Lupoli G A, Fittipaldi M R, Fonderico F, Panico A, Colarusso S, Di Micco L, Cavallo A, Costa L, Paglione A, Lupoli G
Dipartimento di Endocrinologia e Oncologia Molecolare e Clinica, Università degli Studi di Napoli Federico II, Napoli.
Minerva Endocrinol. 2005 Jun;30(2):89-94.
It is well-know that hyperthyroidism is one of the key causes of secondary osteoporosis. High values of thyroid hormones increase the bone mineral turnover speed by promoting osteoclastic and osteoblastic activities. The aim of our study is to evaluate the increase of bone mineral density (BMD) in osteoporotic and hyperthyroid patients treated with only antithyroid drugs versus patients treated with antithyroid drugs and diphosphonates.
Twenty-six elderly male patients, 65-75 years, were selected. In all these patients, thyroid function (FT3, FT4, TSH, Tg, AbTg, AbTPO) was evaluated at baseline and after 6 and 12 months from the start of medical treatment; the following were evaluated: BMD, calcium serum, phosphorus serum, alkaline phosphatase, PTH and 24 hours urinary calcium, phosphorus and hydroxyprolin. Thirteen patients (group 1) were treated with antithyroid drugs (methimazole 5-20 mg/die/os) and diphosphonates (alendronate 10 mg/die/os). The control group of 13 patients (group 2) was treated with antithyroid drugs only.
After 6 months of treatment, the patients of group 1 showed a mean increase of 2.5% in lumbar spine BMD compared with a mean increase of 0.3% in group 2 (p<0.01). After 12 months, group 1 showed a mean increase of 6.2% in lumbar spine BMD, compared with a mean increase of 2% in group (p<0.001).
The combination of antithyroid and diphosphonates drugs appears to be more efficacious than antithyroid therapy alone for the treatment of osteoporosis in male hyperthyroid patients.
众所周知，甲状腺功能亢进是继发性骨质疏松的关键病因之一。甲状腺激素水平升高会通过促进破骨细胞和成骨细胞的活动来加快骨矿物质转换速度。我们研究的目的是评估仅接受抗甲状腺药物治疗的骨质疏松合并甲状腺功能亢进患者与接受抗甲状腺药物和双膦酸盐治疗的患者相比，其骨密度（BMD）的增加情况。
选取26名65至75岁的老年男性患者。对所有这些患者在治疗开始时、治疗6个月和12个月后评估甲状腺功能（FT3、FT4、TSH、Tg、AbTg、AbTPO）；评估以下指标：骨密度、血清钙、血清磷、碱性磷酸酶、甲状旁腺激素以及24小时尿钙、磷和羟脯氨酸。13名患者（第1组）接受抗甲状腺药物（甲巯咪唑5 - 20毫克/日/口服）和双膦酸盐（阿仑膦酸钠10毫克/日/口服）治疗。13名患者的对照组（第2组）仅接受抗甲状腺药物治疗。
治疗6个月后，第1组患者腰椎骨密度平均增加2.5%，而第2组平均增加0.3%（p<0.01）。12个月后，第1组腰椎骨密度平均增加6.2%，而第2组平均增加2%（p<0.001）。
对于男性甲状腺功能亢进患者的骨质疏松治疗，抗甲状腺药物与双膦酸盐联合使用似乎比单纯抗甲状腺治疗更有效。
