| Low-Normal TSH levels are Associated with Low Bone Mineral Density in Healthy Postmenopausal Women |
| 건강한 폐경후 여성에서 정상범위 내에 있는 혈청 TSH농도와 골밀도의 관계 |
| 김덕재,강영호1,정윤이2,고정민,송영기,김기수 |
| 울산대학교 의과대학 서울아산병원 내분비내과, 1예방의학교실, 2서울보훈병원 내분비내과 |
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| Abstract |
Background
Hyperthyroidism is accompanied by low bone mass. Because the reference range of TSH levels is defined statistically, some individuals with low-normal TSH levels may have mild hyperthyroidism and may have reduced bone mass. We therefore determined whether serum TSH levels correlate with bone mineral density (BMD).
Materials and Methods: We measured BMD at the lumbar spine and femoral neck using dual energy X-ray absorptiometry, and serum TSH concentrations using immunoluminometry in healthy postmenopausal women.
Results
BMD at the lumbar spine and femoral neck increased with TSH level (p for trend < 0.001 at both sites). Even after adjustment for age, years since menopause, and body mass index, subjects with low-normal TSH levels (0.5~1.1 mU/L) had significantly lower BMDs at the lumbar spine (0.863±0.009 g/cm2 vs. 0.900±0.009 g/cm2, p=0.004) and femoral neck (0.660±0.006 g/cm2 vs. 0.683±0.006 g/cm2, p=0.006) than those with high-normal TSH levels (2.8~5.0 mU/L), as well as a 2.2 fold increased risk of osteoporosis (95% confidence interval: 1.2~4.0).
Conclusion
These results suggest that low-normal TSH levels may not be physiological for postmenopausal women, and during treatment of hypothyroidism, may not be optimal for avoiding osteoporosis.
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| Key Words:
Thyroid, Bone density, Osteoporosis, TSH, Postmenopausal women |
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