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Journal of Endocrinological Investigation

Erschienen in:

01.10.2021 | Original Article

Trabecular bone score in women with differentiated thyroid cancer on long-term TSH-suppressive therapy

verfasst von: B. É. C. A. Sousa, B. C. Silva, T. de Oliveira Guidotti, M. C. Pires, M. M. S. Soares, A. M. Kakehasi

Erschienen in: Journal of Endocrinological Investigation | Ausgabe 10/2021

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Abstract

Introduction

Thyrotropin stimulating hormone (TSH) suppression in patients with differentiated thyroid cancer (DTC) aims to decrease the growth and proliferation of thyroid cancer cells. However, the effect of TSH-suppressive therapy on bone microarchitecture remains undefined.

Methods

Cross-sectional study including 43 women with DTC undergoing TSH-suppressive therapy (sTSH) compared to 20 women also on levothyroxine (LT4) therapy but with TSH in the low-normal range (nTSH) since the thyroid surgery. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA), and trabecular bone score (TBS) was evaluated using the TBS iNsigth software. Fracture risk assessed by FRAX, with and without TBS, was calculated. The relationship between suppressive therapy-related parameters and bone parameters was investigated.

Results

The TBS mean values were not significantly different in the sTSH and nTSH groups (1.273 ± 0.12 vs 1.307 ± 0.14, p = 0.7197). In both groups, postmenopausal women had degraded microarchitecture (TBS 1.216 ± 0.11 vs 1.213 ± 0.09, p = 0.9333), while premenopausal women had normal microarchitecture (1.328 ± 0.11 vs 1.401 ± 0.12, p = 0.195). The percentage of all postmenopausal women with degraded TBS was 54.7%, while the percentage of osteoporosis diagnoses was 16.1%. The TBS-adjusted FRAX-probability of fracture was similar in sTSH and nTSH groups. Body mass index (BMI) and menopausal status were the only variables associated with TBS and BMD.

Conclusion

Trabecular microarchitecture assessed by TBS was similar between women on long-term suppressive therapy in DTC and those on LT4 replacement therapy aiming at a TSH level within the low-normal reference range. Low TBS values were observed in postmenopausal women of both groups, suggesting that not only suppressed TSH levels but also a low-normal TSH is associated with deteriorated bone microarchitecture in postmenopausal women following total thyroidectomy.

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Titel: Trabecular bone score in women with differentiated thyroid cancer on long-term TSH-suppressive therapy
verfasst von: B. É. C. A. Sousa
B. C. Silva
T. de Oliveira Guidotti
M. C. Pires
M. M. S. Soares
A. M. Kakehasi
Publikationsdatum: 01.10.2021
Verlag: Springer International Publishing
Erschienen in: Journal of Endocrinological Investigation / Ausgabe 10/2021
Elektronische ISSN: 1720-8386
DOI: https://doi.org/10.1007/s40618-021-01537-0

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Trabecular bone score in women with differentiated thyroid cancer on long-term TSH-suppressive therapy

Abstract

Introduction

Methods

Results

Conclusion

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Abstract

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