Sajjinanont Trirat, Rajchadara Samart, Sriassawaamorn Narongchai, Panichkul Suthee
Division of Nuclear Medicine, Department of Radiology, Phramongkutklao Hospital, Bangkok, Thiland.
J Med Assoc Thai. 2005 Nov;88 Suppl 3:S71-6.
To compare bone mineral density (BMD) of lumbar spines (LS) and femoral neck (FN) by Dual energy X-ray absorptiometry (DEXA) in premenopausal well-differentiated thyroid carcinoma women S/P total or near total thyroidectomy with a control group and the effect of Levothyroxine (LT4) to BMD between short term and long term treatment.
DEXA were performed at LS (L1-L4) and FN in 22 premenopausal thyroid carcinoma women S/P total or near total thyroidectomy followed by 1-131 ablation and long term suppressive dose LT4 and 22 healthy premenopausal women.
Mean BMD of LS and FN were not significantly different between thyroid cancer group and control (LS 1.023 +/- 0.088 VS 0.980 +/- 0.075 g/cm2, p > 0.05, FN 0.800 +/- 0.068 VS 0.770 +/ - 0.061 g/cm2, p > 0.05). Period of time taking suppressive doses LT4 was divided into 3 groups (2-5 6-10 yrs and 11-14 yrs). Mean LS BMD +/- S.D of 2-5 yrs, 6-10 yrs and 11-14 yrs therapy are 1.042 +/- 0.135, 1.004 +/- 0.044 and 1.042 +/- 0.055 respectively (p > 0.05). Mean FN BMD +/- S.D of 2-5 yrs, 6-10 yrs and 11-14 yrs therapy are 0.808 +/- 0.084, 0.781 +/- 0.067 and 0.816 +/- 0.013 respectively (p > 0.05).
The suppressive doses LT was not the risk factor of osteoporosis. Although, there was no 4 statistically significant difference of BMD between short and long-term suppressive doses LT groups, the present sample size was not enough to conclude that long-term suppressive doses LT did not decrease BMD.
通过双能X线吸收法(DEXA)比较绝经前分化型甲状腺癌女性在接受全甲状腺切除或近全甲状腺切除术后与对照组腰椎(LS)和股骨颈(FN)的骨密度(BMD),以及左甲状腺素(LT4)短期和长期治疗对骨密度的影响。
对22例绝经前甲状腺癌女性进行全甲状腺切除或近全甲状腺切除术后接受131碘消融及长期抑制剂量LT4治疗,以及22例健康绝经前女性进行腰椎(L1-L4)和股骨颈的DEXA检测。
甲状腺癌组与对照组之间腰椎和股骨颈的平均骨密度无显著差异(腰椎1.023±0.088 vs 0.980±0.075 g/cm²,p>0.05;股骨颈0.800±0.068 vs 0.770±0.061 g/cm²,p>0.05)。服用抑制剂量LT4的时间分为3组(2-5年、6-10年和11-14年)。2-5年、6-10年和11-14年治疗的腰椎平均骨密度±标准差分别为1.042±0.135、1.004±0.044和1.042±0.055(p>0.05)。2-5年、6-10年和11-14年治疗的股骨颈平均骨密度±标准差分别为0.808±0.084、0.781±0.067和0.816±0.013(p>0.05)。
抑制剂量的LT4不是骨质疏松的危险因素。虽然短期和长期抑制剂量LT组之间骨密度无统计学显著差异,但目前样本量不足以得出长期抑制剂量LT4不会降低骨密度的结论。