Zygmunt Arkadiusz, Krawczyk-Rusiecka Kinga, Skowrońska-Jóźwiak Elżbieta, Wojciechowska-Durczyńska Katarzyna, Głowacka Ewa, Adamczewski Zbigniew, Lewiński Andrzej
Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, 93-338 Lodz, Poland.
Department of Laboratory Diagnostics, Research Institute, Polish Mother's Memorial Hospital, 93-338 Lodz, Poland.
J Clin Med. 2021 Oct 24;10(21):4905. doi: 10.3390/jcm10214905.
The direct effect of TSH on bone metabolism in vivo is difficult to capture as the changes of its concentrations are followed by respective alterations of thyroid hormone levels. We evaluated the effect of recombinant human TSH (rhTSH) on sclerostin and other bone markers in 29 patients after total thyroidectomy for differentiated thyroid cancer (DTC), without any signs of disease recurrence, who received L-thyroxine, most at non-suppressive doses. For two consecutive days, the patients were administered a standard dose of 0.9 mg rhTSH, i.m. Concentrations of sclerostin, osteocalcin, β-CrossLaps, PTH, and some other parameters, were measured before and five days after the first rhTSH administration. The greater the increase in TSH concentration (∆TSH), the greater the decrease in: ∆sclerostin (r = -0.672; < 0.001), ∆β-CrossLaps (r = -0.580; < 0.001) and ∆osteocalcin (r = -0.405; = 0.029) levels, were recorded. The degree of TSH increase depended on the baseline PTH (r = 0.651; < 0.001), age, and creatinine concentrations. rhTSH strongly inhibited bone turnover, thus, TSH-independently of thyroid hormones-exerted a direct protective effect on bone metabolism. Baseline PTH affected the magnitude of TSH increase and the degree of lowering in sclerostin and β-CrossLaps that suggest factors affecting PTH may play a role in the effect of TSH on the bone.
促甲状腺激素（TSH）对体内骨代谢的直接作用难以捕捉，因为其浓度变化会伴随甲状腺激素水平的相应改变。我们评估了重组人促甲状腺激素（rhTSH）对29例因分化型甲状腺癌（DTC）行甲状腺全切术后且无任何疾病复发迹象、服用L-甲状腺素（大多为非抑制剂量）患者的硬化蛋白及其他骨标志物的影响。连续两天，患者接受0.9mg标准剂量的rhTSH，肌肉注射。在首次注射rhTSH前及注射后五天，测量硬化蛋白、骨钙素、β-交联C端肽（β-CrossLaps）、甲状旁腺激素（PTH）及其他一些参数的浓度。TSH浓度升高幅度（∆TSH）越大，∆硬化蛋白（r = -0.672；P < 0.001）、∆β-CrossLaps（r = -0.580；P < 0.001）和∆骨钙素（r = -0.405；P = 0.029）水平下降幅度越大。TSH升高程度取决于基线PTH（r = 0.651；P < 0.001）、年龄和肌酐浓度。rhTSH强烈抑制骨转换，因此，TSH独立于甲状腺激素对骨代谢发挥直接保护作用。基线PTH影响TSH升高幅度以及硬化蛋白和β-CrossLaps的降低程度，这表明影响PTH的因素可能在TSH对骨的作用中发挥作用。
