Florkowski C M, Brownlie B E, Elliot J R, Ayling E M, Turner J G
Department of Endocrinology, Christchurch Hospital.
N Z Med J. 1993 Oct 27;106(966):443-4.
Studies of the effect of thyroxine therapy on skeletal integrity have given conflicting results; the reductions in bone mass reported by some have prompted recommendations that the prescribed replacement doses of thyroxine should be reduced. We have examined bone mineral density in a group of patients with differentiated thyroid carcinoma receiving high doses of thyroxine to suppress thyroid stimulating hormone (TSH).
The 44 patients (6 male, 38 female) had a median age of 49 years (range 27-75) with median duration of thyroxine therapy of 9.0 years (range 3 to 42) and mean dose of thyroxine 0.167 mg/day (range 0.125-0.3). TSH levels were chronically suppressed in 39 subjects. Bone mineral density (BMD) was measured by dual energy x-ray absorptiometry (DEXA) in all subjects at the femoral neck and lumbar spine and compared with previously established local reference ranges.
There was no reduction in bone mineral density in the thyroxine treated group compared with the local reference population at both lumbar spine and femoral neck, and no correlation with duration of therapy.
These negative findings, that thyroxine in suppressive doses does not significantly reduce bone mineral density in New Zealand patients suggest that thyroxine therapy alone is not a major risk factor for the development of osteoporosis.
关于甲状腺素治疗对骨骼完整性影响的研究结果相互矛盾；一些研究报告的骨量减少促使人们建议应降低甲状腺素的规定替代剂量。我们研究了一组接受高剂量甲状腺素以抑制促甲状腺激素（TSH）的分化型甲状腺癌患者的骨矿物质密度。
44例患者（6例男性，38例女性），中位年龄49岁（范围27 - 75岁），甲状腺素治疗的中位持续时间为9.0年（范围3至42年），甲状腺素平均剂量为0.167毫克/天（范围0.125 - 0.3）。39名受试者的TSH水平长期受到抑制。所有受试者均通过双能X线吸收法（DEXA）测量股骨颈和腰椎的骨矿物质密度（BMD），并与先前确定的当地参考范围进行比较。
与当地参考人群相比，甲状腺素治疗组在腰椎和股骨颈的骨矿物质密度均未降低，且与治疗持续时间无关。
这些阴性结果表明，在新西兰患者中，抑制剂量的甲状腺素不会显著降低骨矿物质密度，这表明单独的甲状腺素治疗不是骨质疏松症发生的主要危险因素。
