Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec 19;13(1):22640.
doi: 10.1038/s41598-023-50118-z.

Effects of short- and long-term TSH suppression on lumbar bone mineral density in both genders using PET/CT

Holger Einspieler  1 , Christoph Walter  1 , Marcus Hacker  1 , Georgios Karanikas  2 , Dietmar Tamandl  3
Affiliations

Effects of short- and long-term TSH suppression on lumbar bone mineral density in both genders using PET/CT

Holger Einspieler et al. Sci Rep. .

Abstract

Iatrogenic subclinical hyperthyroidism is induced intentionally in patients with differentiated thyroid cancer to reduce the risk of tumor recurrence. This retrospective study aimed to investigate the effect of thyroid-stimulating hormone (TSH) suppressive therapy on bone mineral density in men and women. Two cohorts of endocrine cancer patients were compared. In cohort A, 42 patients with long-lasting suppressed serum TSH were assessed. Cohort B consisted of 41 euthyroid patients. Bone density was measured in the L1-L4 lumbar vertebrae of all patients using PET/CT scans performed for cancer staging. In 17 patients of cohort A who received a second PET/CT scan, bone density was measured again to provide longitudinal analysis. A non-significant difference in age (p = .572) and equal distribution of sex (p = .916) was determined when comparing both cohorts. A significant difference (p = .011) with a moderate effect (η2 = .08; 20.4%) was observed regarding higher bone mineral density (BMD^HU) in cohort B with normal TSH levels (M 160.63 ± 54.7 HU) versus cohort A under TSH suppression therapy (M 127.9 ± 59.5 HU) for a mean duration of 4.45 ± 2.64 years. Furthermore, no significant change in BMD^HU (p = .786) was found in those patients who received a second PET/CT scan after a mean observation time of 2.3 ± 1.2 years. In conclusion, long-lasting TSH suppression therapy caused a statistically significant decrease in BMD^HU while short-lasting therapy didn't. Therefore, we can assume a higher likelihood of osteoporosis in those patients under prolonged TSH suppression.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
TSH distribution (with median) considering both cohorts (logarithmic scaling).
Figure 2
Figure 2
Distribution (with median) of BMD^HU m considering both cohorts.
Figure 3
Figure 3
Bivariate scatterplot depicting change in BMD within the post-therapy time period (T1-T2), adjusting for patient sex with quadratic regression function and CI-95% (n = 17, cohort A).
See this image and copyright information in PMC

References

    1. Ross DS. Serum thyroid-stimulating hormone measurement for assessment of thyroid function and disease. Endocrinol. Metab. Clin. North Am. 2001;30:245–264. doi: 10.1016/S0889-8529(05)70186-9. - DOI - PubMed
    1. Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch. Intern. Med. 2000;160:526–534. doi: 10.1001/archinte.160.4.526. - DOI - PubMed
    1. Marqusee E, Haden ST, Utiger RD. Subclinical thyrotoxicosis. Endocrinol. Metab. Clin. North Am. 1998;27:37–49. doi: 10.1016/S0889-8529(05)70296-6. - DOI - PubMed
    1. Wang C, Crapo LM. The epidemiology of thyroid disease and implications for screening. Endocrinol. Metab. Clin. North Am. 1997;26:189–218. doi: 10.1016/S0889-8529(05)70240-1. - DOI - PubMed
    1. Sawin CT, et al. Low serum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons. N. Engl. J. Med. 1994;331:1249–1252. doi: 10.1056/NEJM199411103311901. - DOI - PubMed