Korean J Bone Metab > Volume 10(2); 2003 > Article
Korean Journal of Bone Metabolism 2003;10(2):185-192.
Biochemical Markers of Bone Turnover and Bone Density in Patients with Subclinical Thyrotoxicosis According to Menopausal Status
무증상 갑상선중독증에서 폐경에 따른 골밀도 및 골표지자의 비교
김해성,윤홍선,한승석,최현아,김성훈,임창훈,정호연,한기옥,박원근,윤현구,한인권
성균관대학교 의과대학 삼성제일병원 내과
Abstract
Background
It is well established that thyroid hormone stimulates bone resorption, causing increased development of osteoporosis in thyrotoxicosis, and recent studies have shown that even subclinical thyrotoxicosis leads to reduced bone mineral density (BMD) and increased biochemical levels of bone turnover. However, levels of bone turnover markers and BMD may vary significantly with age, sex, and menopausal status, and therefore, studies designed with these factors adjusted are needed. Method: Sixty-one women diagnosed with subclinical thyrotoxicosis from their routine physical check-up between January 2000 and July 2002 were included in this study. They had normal free thyroxine (FT4) and decreased thyroid stimulating hormone (TSH) (below 0.2 mU/L) levels. The control group consisted of 183 healthy women matched for age and menopausal status, without any history of thyroid disease and with normal FT4 and TSH levels. Serum osteocalcin and alkaline phosphatase, urinary deoxypyridinoline, and the lumbar BMD between the patient and the control group were compared. Result: Both urinary deoxypyridinoline (10.25±5.52, 8.14±2.69 nmol/mmol Cr, p=0.005) and serum alkaline phosphatase (79.69±28.78, 69.94±22.33 IU/L, p=0.015) levels were significantly higher in the subclinical thyrotoxicosis group than the control group. However, when each group was stratified by the menopausal status into pre-, peri-, and postmenopausal subgroups, the differences in these markers remained significant only in the postmenopausal subgroup and not in the premenopausal subgroup. Meanwhile, serum osteocalcin and lumbar BMD were not significantly different between the subclinical thyrotoxicosis and control groups.
Conclusion
Bone resorption is increased in subclinical thyrotoxicosis, and preventive measures are needed to deter further bone loss especially in middle-aged thyrotoxic women, with greater risk of bone loss due to their menopausal status. Thyroid function test may be routinely p
Key Words: Subclinical thyrotoxicosis, Bone density, Bone marker


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