Impact of severity, duration, and etiology of hyperthyroidism on bone turnover markers and bone mineral density in men

BMC Endocrine Disorders

Mohamed Abou El Atta¹  Soma Sh Abd El Gawad³  Mohamed Ghonaim²  El Hadidy M El Hadidy² 

[1] Diagnostic Radiology Department, Faculty of Medicine, Mansoura University, Egypt;Internal Medicine Department, Faculty of Medicine, Mansoura University, Egypt;Clinical Pathology Department, Faculty of Medicine, Mansoura University, Egypt

关键词: Osteoporosis;    Hyperthyroidism;    Bon resorption markers;    Bone formation markers;    Bone mineral density;   

Others  :  1086506
DOI  :  10.1186/1472-6823-11-15

 received in 2011-03-24, accepted in 2011-08-06,  发布年份 2011

【 摘 要 】

Background

Hyperthyroidism is accompanied by osteoporosis with higher incidence of fracture rates. The present work aimed to study bone status in hyperthyroidism and to elucidate the impact of severity, duration, and etiology of hyperthyroidism on biochemical markers of bone turnover and bone mineral density (BMD).

Methods

Fifty-two male patients with hyperthyroidism, 31 with Graves' disease (GD) and 21 with toxic multinodular goiter (TNG), with an age ranging from 23 to 65 years were included, together with 25 healthy euthyroid men with matched age as a control group. In addition to full clinical examination, patients and controls were subjected to measurement of BMD using dual-energy X-ray absorptiometery scanning of the lower half of the left radius. Also, some biochemical markers of bone turnover were done for all patients and controls.

Results

Biochemical markers of bone turnover: included serum bone specific alkaline phosphatase, osteocalcin, carboxy terminal telopeptide of type l collagen also, urinary deoxypyridinoline cross-links (DXP), urinary DXP/urinary creatinine ratio and urinary calcium/urinary creatinine ratio were significantly higher in patients with GD and TNG compared to controls (P < 0.01). However, there was non-significant difference in these parameters between GD and TNG patients (P > 0.05). BMD was significantly lower in GD and TNG compared to controls, but the Z-score of BMD at the lower half of the left radius in patients with GD (-1.7 ± 0.5 SD) was not significantly different from those with TNG (-1.6 ± 0.6 SD) (>0.05). There was significant positive correlation between free T3 and free T4 with biochemical markers of bone turnover, but negative correlation between TSH and those biochemical markers of bone turnover. The duration of the thyrotoxic state positively correlated with the assessed bone turnover markers, but it is negatively correlated with the Z-score of BMD in the studied hyperthyroid patients (r = -0.68, P < 0.0001).

Conclusion

Men with hyperthyroidism have significant bone loss with higher biochemical markers of bone turnover. The severity and the duration of the thyrotoxic state are directly related to the derangement of biochemical markers of bone turnover and bone loss.

【 授权许可】

   
2011 El Hadidy et al; licensee BioMed Central Ltd.

【 图 表 】

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