Kim Eun Heui, Jeon Yun Kyung, Pak Kyoungjune, Kim In-Joo, Kim Seong-Jang, Shin Seunghyeon, Kim Bo Hyun, Kim Sang Soo, Lee Byung-Joo, Lee Jeong-Gyu, Goh Tae Sik, Kim Keunyoung
Division of Endocrinology and Metabolism, Department of Internal Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
J Bone Metab. 2019 Feb;26(1):31-38. doi: 10.11005/jbm.2019.26.1.31. Epub 2019 Feb 28.
This study examined the change in the trabecular bone score (TBS), areal bone mineral density (aBMD), and osteoporosis in postmenopausal women who underwent thyrotropin (TSH)-suppressive therapy for treating papillary thyroid cancer after a total thyroidectomy procedure.
We evaluated 36 postmenopausal women who received a total thyroidectomy for papillary thyroid cancer and were undergoing TSH suppressive therapy with levothyroxine. Postmenopausal women (n=94) matched for age and body mass index were recruited as healthy controls. The aBMD and TBS of the lumbar spine were compared between dual energy X-ray absorptiometry (DXA) at baseline and at follow-up after an average of 4.92 years.
There was no significant difference in the rate of diagnoses of osteoporosis, osteopenia, or normal bone status between the 2 groups during the baseline DXA evaluation. However, the TBS was significantly lower whereas aBMD did not show significant difference at the time of baseline DXA measurement (1st DXA, 1.343±0.098 vs. 1.372±0.06317, <0.001; 2nd DXA, 1.342±0.095 vs. 1.370±0.062, <0.001). The TBS and aBMD did not differ significantly between the initial and follow-up DXA images in both groups of TSH suppressive patients and controls.
The average value of TBS and aBMD did not significantly change during the follow-up period. The TSH suppressive therapy was revealed as not a significant factor for the progressive deterioration of bone status during long term follow-up.
本研究调查了接受促甲状腺激素（TSH）抑制治疗以治疗甲状腺全切术后乳头状甲状腺癌的绝经后女性的小梁骨评分（TBS）、骨面积密度（aBMD）及骨质疏松情况的变化。
我们评估了36例接受乳头状甲状腺癌甲状腺全切术并接受左甲状腺素TSH抑制治疗的绝经后女性。招募年龄和体重指数匹配的绝经后女性（n = 94）作为健康对照。在基线及平均4.92年随访后，采用双能X线吸收法（DXA）比较腰椎的aBMD和TBS。
在基线DXA评估期间，两组间骨质疏松、骨量减少或骨状态正常的诊断率无显著差异。然而，在基线DXA测量时，TBS显著较低，而aBMD无显著差异（第一次DXA，1.343±0.098 vs. 1.372±0.06317，<0.001；第二次DXA，1.342±0.095 vs. 1.370±0.062，<0.001）。TSH抑制治疗组和对照组的初始和随访DXA图像之间，TBS和aBMD无显著差异。
随访期间TBS和aBMD的平均值无显著变化。结果显示，TSH抑制治疗并非长期随访期间骨状态进行性恶化的显著因素。
