Международный эндокринологический журнал Том 14, №4, 2018
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Bone mineral density in patients with hypothyroidism
Авторы: Pankiv I.V.
Higher State Educational Institution of Ukraine «Bukovinian State Medical University», Chernivtsi, Ukraine
Рубрики: Эндокринология
Разделы: Медицинские форумы
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Thyroid dysfunction is associated with a broad range of metabolic disturbances and conditions such as osteoporosis, hypercholesterolemia, obesity, and cardiovascular disease. The purpose of this study was to investigate relationship between osteoporosis and osteopenia in patients with primary hypothyroidism.
Materials and methods. A total of 95 women aged over 50 years were assigned to one of three study groups: Group I consisted 35 patients who had been recently diag–nosed primary hypothyroidism. The second groups of 35 patients diagnosed primary hypothyroidism for at least 3 years and were treated with levothyroxine (Group II). The third group of 25 healthy individuals was selected as a control group (Group III); these people were selected from the women with the same age who had not any symptoms of hypothyroidism, and their serum TSH was in the normal range. The bone density based on the T-score of femoral neck and lumbar vertebrae were compared between three groups. For densitometry, dual-energy X-ray absorptiometry was used to measure the bone density in lumbar vertebrae (L2–L4, anterior-posterior measurements) and femoral neck.
Results. There were no statistically significant differences of body mass index (BMI), femoral neck T-score and menopausal age between the three groups. Baseline serum TSH levels were significantly differ-ent among three groups (p < 0.001). Serum TSH in Group I was higher than the other groups; while serum TSH in Group II was lower than Group III (p < 0.001). The femoral neck T-score was not significantly different between the three groups; however, the T-score at lumbar spine L2–L4 regions were signifi-cantly different (p = 0.01). Prevalence of osteoporosis was 40 % in Group II that was higher than other groups. The mean T-score at lumbar spine L2–L4 region between Groups II and III (p = 0.02) and between Groups I and II (p = 0.03) were significantly different. Mean serum TSH levels and mean T-score at lumbar spine L2–L4 region in Group II was lower than the other two groups. Regression analysis has not shown any correlation between serum TSH levels and T-score at femoral neck and lumbar spine (p > 0.05); however, after re-moving the effect of the baseline TSH level in Group II, a significant difference in the prevalence of osteoporosis at the lumbar spine were found between groups (p = 0.01).
Conclusions. Prevalence of osteoporosis was 42.9 % in patients with primary hypothyroidism treated with levothyroxine for at least 3 years. Among untreated hypothyroid patients osteoporosis was diagnosed in 31.4 %. Significant difference in the prevalence of osteoporosis at the lumbar spine were found between these groups. Thus, simultaneous treatment of hypothyroidism and bone loss seems to be necessary.