Trabecular bone deterioration in differentiated thyroid cancer: Impact of long‐term TSH suppressive therapy

Autor: Begoña López Alvarez, Federico Hawkins Carranza, Gonzalo Allo Miguel, María Luisa De Mingo Dominguez, Cristina Martín-Arriscado Arroba, Sonsoles Guadalix Iglesias, Guillermo Martínez Díaz-Guerra
Rok vydání: 2020
Předmět:
0301 basic medicine
endocrine system
Cancer Research
medicine.medical_specialty
Time Factors
trabecular bone score
endocrine system diseases
thyrotropin suppressive therapy
medicine.medical_treatment
Osteoporosis
Group ii
Levothyroxine
Urology
Thyrotropin
lcsh:RC254-282
03 medical and health sciences
Absorptiometry
Photon
0302 clinical medicine
Trabecular bone score
Bone Density
Humans
Medicine
Radiology
Nuclear Medicine and imaging
Thyroid Neoplasms
differentiated thyroid carcinoma
Thyroid cancer
Original Research
Bone mineral
business.industry
Thyroidectomy
Clinical Cancer Research
Middle Aged
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
medicine.disease
Thyroxine
Trabecular bone
030104 developmental biology
Oncology
030220 oncology & carcinogenesis
Cancellous Bone
Multivariate Analysis
Female
bone mineral density
business
Follow-Up Studies
medicine.drug
Zdroj: Cancer Medicine
Cancer Medicine, Vol 9, Iss 16, Pp 5746-5755 (2020)
ISSN: 2045-7634
DOI: 10.1002/cam4.3200
Popis: Background Conflicting results has been reported regard osteoporosis and fractures in patients with Differentiated Thyroid Cancer (DTC). Our objective was to evaluate the long‐term effects of TSH suppression therapy with Levothyroxine (LT4) on trabecular bone score (TBS) and bone mineral density (BMD) in females with DTC after thyroidectomy. Methods About 145 women with resected DTC and receiving long‐term TSH therapy, were stratified according to the degree of TSH suppression. Mean duration of follow‐up was 12.3 ± 6.1 years. BMD and TBS, were assessed using dual‐energy X‐ray absorptiometry (DXA) and TBS iNsight (Med‐Imaps), at baseline (1‐3 months after surgery) and at the final study visit. Results In patients stratified by duration of TSH suppression therapy (Group I, 5‐10 years; Group II, >10 years), slight increases from baseline TSH levels were observed. Significant decreases in LS‐BMD and FN‐BMD were seen in patients after >10 years. TBS values were lower in Groups I (1.289 ± 0.122) and II (1.259 ± 0.129) compared with baseline values (P = .0001, both groups). Regarding the degree of TSH suppression, TBS was significantly reduced in those with TSH 0.5 µU/mL. Conclusions We found deterioration of trabecular structure in patients with DTC and TSH suppression therapy below 0.1 µU/mL and after 5‐10 years of follow‐up. Significant changes in BMD according to TSH levels were not observed. Trabecular Bone Score is a useful technique for identifying thyroid cancer patients with risk of bone deterioration.
There is a debate respect the effect of long‐term TSH suppression therapy in Thyroid Cancer. We have demonstrated according to the degree of suppression and duration (Group I, 5‐10 years; Group II, >10 years): TBS values were lower in Groups I (1.29 ± 0.12) and II (1.26 ± 0.13) compared with baseline values while decreases in L‐BMD and FN‐BMD were seen in patients after >10 years. Regarding the degree of TSH suppression, TBS was significantly reduced in those with TSH 0.5 µU/mL. We described for the first time deterioration of trabecular structure in patients with DTC and TSH suppression therapy below 0.1 µU/mL and after 5‐10 years of follow‐up. Significant changes in BMD according to TSH levels were not observed. Therefore we support Trabecular Bone Score as a useful technique for identifying thyroid cancer patients with risk of bone fracture.
Databáze: OpenAIRE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje