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Kuliczkowska-Płaksej J, Zdrojowy-Wełna A, Jawiarczyk-Przybyłowska A, Gojny Ł, Bolanowski M. Diagnosis and therapeutic approach to bone health in patients with hypopituitarism. Rev Endocr Metab Disord 2024; 25:513-539. [PMID: 38565758 DOI: 10.1007/s11154-024-09878-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2024] [Indexed: 04/04/2024]
Abstract
The results of many studies in recent years indicate a significant impact of pituitary function on bone health. The proper function of the pituitary gland has a significant impact on the growth of the skeleton and the appearance of sexual dimorphism. It is also responsible for achieving peak bone mass, which protects against the development of osteoporosis and fractures later in life. It is also liable for the proper remodeling of the skeleton, which is a physiological mechanism managing the proper mechanical resistance of bones and the possibility of its regeneration after injuries. Pituitary diseases causing hypofunction and deficiency of tropic hormones, and thus deficiency of key hormones of effector organs, have a negative impact on the skeleton, resulting in reduced bone mass and susceptibility to pathological fractures. The early appearance of pituitary dysfunction, i.e. in the pre-pubertal period, is responsible for failure to achieve peak bone mass, and thus the risk of developing osteoporosis in later years. This argues for the need for a thorough assessment of patients with hypopituitarism, not only in terms of metabolic disorders, but also in terms of bone disorders. Early and properly performed treatment may prevent patients from developing the bone complications that are so common in this pathology. The aim of this review is to discuss the physiological, pathophysiological, and clinical insights of bone involvement in pituitary disease.
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Affiliation(s)
- Justyna Kuliczkowska-Płaksej
- Department and Clinic of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wybrzeże Pasteura 4, Wrocław, 50-367, Poland
| | - Aleksandra Zdrojowy-Wełna
- Department and Clinic of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wybrzeże Pasteura 4, Wrocław, 50-367, Poland
| | - Aleksandra Jawiarczyk-Przybyłowska
- Department and Clinic of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wybrzeże Pasteura 4, Wrocław, 50-367, Poland.
| | - Łukasz Gojny
- Department and Clinic of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wybrzeże Pasteura 4, Wrocław, 50-367, Poland
| | - Marek Bolanowski
- Department and Clinic of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wybrzeże Pasteura 4, Wrocław, 50-367, Poland
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Sowińska-Przepiera E, Krzyścin M, Syrenicz I, Ćwiertnia A, Orlińska A, Ćwiek D, Branecka-Woźniak D, Cymbaluk-Płoska A, Bumbulienė Ž, Syrenicz A. Evaluation of Trabecular Bone Microarchitecture and Bone Mineral Density in Young Women, Including Selected Hormonal Parameters. Biomedicines 2024; 12:758. [PMID: 38672114 PMCID: PMC11048270 DOI: 10.3390/biomedicines12040758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/24/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
The absence of non-invasive methods for assessing bone material and structural changes is a significant diagnostic challenge. Dual-energy X-ray absorptiometry (DXA) bone mineral density (BMD) testing is the gold standard for osteoporosis diagnosis. BMD and the trabecular bone score (TBS) have facilitated targeted osteoporosis prevention and treatment in clinical settings. The findings from this study indicate that BMD modulation in young women is influenced by various hormones, potentially compromising the diagnostic precision of BMD for subclinical bone demineralization. A total of 205 women aged 19 to 37 underwent anthropometric measurements and hormonal tests. BMD was determined using DXA, and TBS values were computed from the lumbar spine L1-L4 segment. The multivariate analysis findings suggest that BMD might not be determined by hormones. The relationship between TBS and TSH was statistically significant in the univariate analysis, which indicates the efficacy of further studies to determine the link between TBS and specific hormones. Analyzing the strength of the correlation between TBS and hormones in the univariate analysis shows which factors are worth considering in further analyses. This makes it possible to create better techniques that will help identify young women who are at a higher risk of developing osteoporosis.
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Affiliation(s)
- Elżbieta Sowińska-Przepiera
- Pediatric, Adolescent Gynecology Clinic, Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland;
- Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland; (I.S.); (A.S.)
| | - Mariola Krzyścin
- Pediatric, Adolescent Gynecology Clinic, Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland;
| | - Igor Syrenicz
- Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland; (I.S.); (A.S.)
| | - Adrianna Ćwiertnia
- Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.Ć.); (A.O.); (A.C.-P.)
| | - Adrianna Orlińska
- Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.Ć.); (A.O.); (A.C.-P.)
| | - Dorota Ćwiek
- Department of Obstetrics and Pathology of Pregnancy, Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland;
| | - Dorota Branecka-Woźniak
- Department of Gynecology and Reproductive Health, Pomeranian Medical University of Szczecin, Żołnierska 48, 71-210 Szczecin, Poland;
| | - Aneta Cymbaluk-Płoska
- Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.Ć.); (A.O.); (A.C.-P.)
| | - Žana Bumbulienė
- Clinic of Obstetrics and Gynecology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, LT-08661 Vilnius, Lithuania;
| | - Anhelli Syrenicz
- Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland; (I.S.); (A.S.)
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Lu C, Dharmalingam M, R MP, Y P G, Selvan C, Kalra P. Bone Mineral Density and Bone Turnover Marker in a Subclinical Thyrotoxic State in Young Premenopausal Women. Cureus 2024; 16:e52610. [PMID: 38374858 PMCID: PMC10875710 DOI: 10.7759/cureus.52610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Subclinical thyrotoxicosis (SCH) is characterized by normal serum thyroid hormone levels and low thyrotropin levels. The impact of this condition on the skeletal system may vary depending on its cause, yet the relationship is not fully comprehended in premenopausal women. Studies are scarce about its effects on bone health in our population. OBJECTIVES This study aims to evaluate the bone mineral density (BMD) and bone turnover markers in premenopausal women with SCH and determine if any differences exist based on the condition's etiology. METHODS A cross-sectional study was conducted at Ramaiah Medical College involving 36 participants for one year and six months after approval from the Ethics Committee. The carboxy-terminal telopeptide of type I collagen in blood and BMD were measured at the lumbar vertebrae (L1-L4) and femoral neck by dual-energy x-ray absorptiometry (Hologic v 2.0, Hologic, Massachusetts, U.S.). Statistical analysis was done using IBM SPSS Statistics for Windows, Version 20 (Released 2011; IBM Corp., Armonk, New York, United States). Results: The mean age of the study population was 35.2 ± 7.2 years. The etiology was Graves' disease [n=11 (33.3%)], iatrogenic [n=14(38.8%)], toxic adenoma [n=6 (15.1%)], and multi-nodular goiter [n=5 (15.1%)]. The mean BMI was 23.5 ± 3.8 kg/m2, and the mean levels of corrected calcium, phosphorus, and 25 hydroxy-vitamin D were 9.12 ± 0.25 mg/dl, 2.95 ± 0.34 mg/dl, and 29.4 ± 6.4 ng/ml, respectively. The mean BMD at hip and spine was 0.81 ±0.16 g/cm2 and 0.92±0.08 g/cm2 respectively. The mean Z-score was (-0.02 ± 0.8) and (-0.92± 0.08) at the hip and spine. No significant difference was observed in the BMD at the hip (p = 0.14) or spine (p = 0.44) between the endogenous and exogenous subclinical thyrotoxic subgroups. At the same time, the carboxy-terminal telopeptide of type I collagen was significantly different between the two groups (p<0.05). CONCLUSION In our cross-sectional study of premenopausal women with SCH, BMD at the hip or spine as measured by dual-energy X-ray absorptiometry did not reveal any significant reduction. The subclinical thyrotoxic state may not have an adverse effect on bone health in premenopausal females with sufficient levels of serum 25-hydroxy-vitamin D in the short term.
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Affiliation(s)
- Chirag Lu
- Endocrinology and Diabetes, Ramaiah Medical College, Bengaluru, IND
| | - Mala Dharmalingam
- Endocrinology and Diabetes, Bangalore Endocrinology and Diabetes Research Centre, Bengaluru, IND
| | - Manjunath P R
- Endocrinology and Diabetes, Ramaiah Medical College, Bengaluru, IND
| | - Ganavi Y P
- Endocrinology and Diabetes, Ramaiah Medical College, Bengaluru, IND
| | - Chitra Selvan
- Endocrinology and Diabetes, Ramaiah Medical College, Bengaluru, IND
| | - Pramila Kalra
- Endocrinology and Diabetes, Ramaiah Medical College, Bengaluru, IND
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Cheng CW, Fang WF, Lin JD. Associations of serum keratin 1 with thyroid function and immunity in Graves' disease. PLoS One 2023; 18:e0289345. [PMID: 38019813 PMCID: PMC10686460 DOI: 10.1371/journal.pone.0289345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 07/08/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Autoimmune thyroid disease (AITD) can cause enormous health burdens; however, trustworthy biomarkers in identifying the onset and progression of AITD are limited. In this study, we attempted to discover new potential serum biomarkers to discriminate AITD using mass spectrometry (MS). METHODS In the biomarker study cohort, 20 patients with Graves' disease (GD), 20 patients with Hashimoto's thyroiditis (HT), and 20 healthy controls were enrolled for a liquid chromatographic-tandem MS assessment. A novel biomarker, keratin 1 (KRT1), was selected for further evaluation in the validation cohort, including 125 patients with GD, 34 patients with HT, and 77 controls. Relationships of serum KRT1 with AITD-related immunomodulatory cytokines were also analyzed using enzyme-linked immunosorbent assays (ELISAs). RESULTS In the MS analysis, KRT1 was the single marker overexpressed in GD, while it was underexpressed in HT. In the ELISA analysis of the validation cohort, KRT1 was consistently upregulated in GD, while it was not downregulated in HT. There were significant associations of KRT1 levels with thyroid function in GD, AITD, and overall subjects. Additionally, a significant association of KRT1 levels with thyroid-stimulating hormone receptor antibody (TSHRAb) levels was observed. Moreover, there were significant associations of KRT1 with osteopontin (OPN) and B-cell activating factor (BAFF) levels in GD. CONCLUSIONS Serum KRT1 levels were upregulated in GD and were associated with thyroid function and TSHRAb levels. Moreover, KRT1 was correlated with the BAFF and OPN levels in GD patients. Further molecular-based research to elucidate the role of KRT1 in the pathogenesis of AITD is needed.
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Affiliation(s)
- Chao-Wen Cheng
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Traditional Herb Medicine Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
- Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | | | - Jiunn-Diann Lin
- Department of Internal Medicine, Division of Endocrinology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Branstetter RM, Islam RK, Toups CA, Parra AN, Lee Z, Ahmadzadeh S, Varrassi G, Shekoohi S, Kaye AD. Mechanisms and Treatment Options for Hyperthyroid-Induced Osteoporosis: A Narrative Review. Cureus 2023; 15:e48798. [PMID: 38098934 PMCID: PMC10720926 DOI: 10.7759/cureus.48798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/14/2023] [Indexed: 12/17/2023] Open
Abstract
Normal thyroid hormone levels are crucial for the homeostasis of many metabolic cycles and processes throughout the human body. Thyroid dysfunction, such as thyrotoxicosis, can result from many different etiologies, including Graves' disease (GD), toxic multinodular goiter (MNG), and toxic adenoma. These hyperthyroid disease states can cause devastating complications and disease, including the disruption of the bone remodeling cycle and skeletal development, which can result in osteoporosis. Osteoporosis is characterized by a decrease in bone mineral density and a propensity for fragility fractures. In addition to patients with overt hyperthyroidism, studies have provided evidence of other high-risk patient demographics, such as individuals with subclinical hyperthyroidism and postmenopausal women, who may be at an increased risk for the development of secondary osteoporosis. The treatment of patients with hyperthyroid-induced osteoporosis often requires a multifaceted management plan that may be unique to each patient's situation. Antithyroid therapy is often the first step in treating this disease and may include thioamide medications. Radioactive iodine-131 therapy (RAI) and the surgical removal of the thyroid gland may also be reasonable approaches for restoring normal thyroid function. Following thyrotoxicosis mitigation, antiresorptive drugs such as bisphosphonates, calcitonin, and selective estrogen receptor modulators (SERMs) may be used to counteract decreased bone mineral density (BMD). Additionally, the implementation of vitamin D, calcium supplements, and weight-bearing exercise may also reduce bone loss. While the effects of thyroid stimulating hormone (TSH) and triiodothyronine (T3) on bone remodeling have been studied in the past, more research is needed to identify unknown mechanisms and develop future improved treatments for this condition.
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Affiliation(s)
- Robert M Branstetter
- School of Medicine, Louisiana State University Health School of Medicine, New Orleans, USA
| | - Rahib K Islam
- School of Medicine, Louisiana State University Health School of Medicine, New Orleans, USA
| | - Collin A Toups
- School of Medicine, Louisiana State University Health School of Medicine, New Orleans, USA
| | - Amanda N Parra
- School of Medicine, Ross University School of Medicine, Miramar, USA
| | - Zachary Lee
- Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Shahab Ahmadzadeh
- Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA
| | | | - Sahar Shekoohi
- Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA
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6
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Choo KS, Dacay LM, Chong LR, Gani LU. Persistent Bilateral Atypical Femoral Fractures in an Antiresorptive-Naïve Singaporean Chinese Patient with Graves' Disease. J ASEAN Fed Endocr Soc 2023; 38:135-140. [PMID: 38045669 PMCID: PMC10692435 DOI: 10.15605/jafes.038.02.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 03/24/2023] [Indexed: 12/05/2023] Open
Abstract
Atypical femoral fractures (AFFs) are rare adverse effects of bisphosphonate therapy. We report an unusual case of bilateral diaphyseal AFFs in an antiresorptive-naïve Singaporean Chinese female with Graves' disease. She presented with complete right AFF requiring surgical fixation, and persistent left incomplete AFF for over four years. Femoral bowing, varus femoral geometry, and ethnic influence likely contributed to the AFFs' formation. This case may provide insights into the pathogenesis of AFFs in high-risk Asian populations.
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Affiliation(s)
- Kuan Swen Choo
- Department of Endocrinology, Changi General Hospital, Singapore
| | - Lily Mae Dacay
- Department of Endocrinology, Changi General Hospital, Singapore
| | - Le Roy Chong
- Department of Radiology, Changi General Hospital, Singapore
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Mudri D, Bilić Ćurčić I, Meštrović L, Mihaljević I, Kizivat T. Hyperthyroidism and Wnt Signaling Pathway: Influence on Bone Remodeling. Metabolites 2023; 13:metabo13020241. [PMID: 36837860 PMCID: PMC9968154 DOI: 10.3390/metabo13020241] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/28/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
Graves' disease is an autoimmune disease of the thyroid gland, characterized by increased production of thyroid hormones, which can affect many different organ systems in the body. Among other problems, it can cause disorders of the skeletal system, shortening the bone remodeling cycle and causing a decrease in bone density. The Wnt cascade signaling pathway and the β-catenin, as a part of the canonical Wnt pathway, also play roles in maintaining bone mass. Inhibition of the Wnt pathway can cause bone loss, and its stimulation can increase it. The Wnt signaling pathway influences the effectiveness of thyroid hormones by affecting receptors for thyroid hormones and deiodinase, while thyroid hormones can change levels of β-catenin within the cell cytoplasm. This indicates that the Wnt pathway and thyroid hormone levels, including hyperthyroidism, are linked and may act together to change bone density. In this review article, we attempt to explain the interplay between thyroid hormones and the Wnt pathway on bone density, with a focus on directions for further research and treatment options.
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Affiliation(s)
- Dunja Mudri
- Department of Nuclear Medicine and Oncology, Faculty of Medicine, University of Osijek, 31000 Osijek, Croatia
- Clinical Institute of Nuclear Medicine and Radiation Protection, University Hospital Osijek, 31000 Osijek, Croatia
| | - Ines Bilić Ćurčić
- Department of Pharmacology, Faculty of Medicine, University of Osijek, 31000 Osijek, Croatia
- Department of Endocrinology and Metabolism Disorders, University Hospital Osijek, 31000 Osijek, Croatia
- Correspondence: (I.B.Ć.); (T.K.)
| | - Lucija Meštrović
- Faculty of Medicine, University of Osijek, 31000 Osijek, Croatia
| | - Ivica Mihaljević
- Department of Nuclear Medicine and Oncology, Faculty of Medicine, University of Osijek, 31000 Osijek, Croatia
- Clinical Institute of Nuclear Medicine and Radiation Protection, University Hospital Osijek, 31000 Osijek, Croatia
- Academy of Medical Sciences of Croatia, 31000 Osijek, Croatia
| | - Tomislav Kizivat
- Department of Nuclear Medicine and Oncology, Faculty of Medicine, University of Osijek, 31000 Osijek, Croatia
- Clinical Institute of Nuclear Medicine and Radiation Protection, University Hospital Osijek, 31000 Osijek, Croatia
- Correspondence: (I.B.Ć.); (T.K.)
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Vinther CJ, Poulsen LH, Nicolaisen P, Obling ML, Brix TH, Hermann AP, Hegedüs L, Jørgensen NR, Hansen S, Bonnema SJ. Do bone turnover markers reflect changes in bone microarchitecture during treatment of patients with thyroid dysfunction? J Endocrinol Invest 2023; 46:345-358. [PMID: 36064878 DOI: 10.1007/s40618-022-01907-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 08/19/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE This study aimed to compare changes in the bone turnover markers (BTMs)-C-terminal telopeptide of type I collagen (CTX-I) and procollagen I N-terminal peptide (PINP)-with changes in the bone microarchitecture, assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT), during treatment of patients with thyroid dysfunction. METHODS In women with newly diagnosed hypo- or hyperthyroidism, HR-pQCT variables, obtained from the tibia and the radius, were compared with BTMs. Data were collected at diagnosis and after at least 12 months of euthyroidism. RESULTS 73 women completed the study (hypothyroidism, n = 27; hyperthyroidism, n = 46). Among hyperthyroid patients, correlations were found between changes in BTMs and HR-pQCT variables, primarily for cortical variables in the tibia, i.e. cortical thickness (CTX-I, p < 0.001; PINP, p < 0.001), and volumetric bone mass density (vBMD) (CTX-I, p < 0.001; PINP, p < 0.001). Moreover, correlations between BTMs and estimated bone strength were found. In the hypothyroid subgroup, no significant findings existed after adjustment. Following treatment, less decrease in tibial vBMD was seen among patients with increasing CTX-I compared to those with a decreasing CTX-I level (p = 0.009). Opposite findings applied to PINP, as patients with decreasing PINP showed an increase in tibial vBMD, in contrast to a decline in this parameter among patients with increasing PINP (p < 0.001). CONCLUSION Changes in CTX-I and PINP correlated with HR-pQCT variables during the treatment of women with thyroid dysfunction. To some extent, these BTMs reflected the restoration of bone microarchitecture. CTX-I seems to be the most sensitive BTM in treatment-naïve thyroid diseases, while PINP is more useful for monitoring during treatment. TRIAL REGISTRATION NUMBER NCT02005250. Date: December 9, 2013.
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Affiliation(s)
- C J Vinther
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - L H Poulsen
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - P Nicolaisen
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - M L Obling
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - T H Brix
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - A P Hermann
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - L Hegedüs
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - N R Jørgensen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Clinical Chemistry, Rigshospitalet, Glostrup, Denmark
| | - S Hansen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Medicine, Hospital of South-West Jutland, Esbjerg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - S J Bonnema
- Department of Endocrinology, Odense University Hospital, Odense, Denmark.
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Daya NR, Fretz A, Martin SS, Lutsey PL, Echouffo-Tcheugui JB, Selvin E, Juraschek SP. Association Between Subclinical Thyroid Dysfunction and Fracture Risk. JAMA Netw Open 2022; 5:e2240823. [PMID: 36346629 PMCID: PMC9644261 DOI: 10.1001/jamanetworkopen.2022.40823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
IMPORTANCE Clinical hyperthyroidism accelerates bone resorption without compensatory bone formation, reducing bone density and increasing the risk of fracture. The association between subclinical hyperthyroidism and fracture risk is less clear. OBJECTIVE To investigate the association of endogenous subclinical thyroid dysfunction and fracture risk, independent of clinical confounders. DESIGN, SETTING, AND PARTICIPANTS This cohort study included 10 946 participants from the Atherosclerosis Risk in Communities Study, an ongoing prospective cohort study of community-dwelling individuals conducted from 1987-1989 through December 31, 2019, in Washington County, Maryland; Forsyth County, North Carolina; Jackson, Mississippi; and the suburbs of Minneapolis, Minnesota. Participants were not taking thyroid medications and had no history of fractures. EXPOSURES Thyrotropin and free thyroxine levels were measured at visit 2 (1990-1992). Subclinical hyperthyroidism was defined as a thyrotropin level lower than 0.56 mIU/L, subclinical hypothyroidism as a thyrotropin level higher than 5.1 mIU/L, and euthyroidism as a thyrotropin level of 0.56 to 5.1 mIU/L, with normal free thyroxine levels from 0.85 to 1.4 ng/dL. MAIN OUTCOMES AND MEASURES Incident fracture was ascertained using hospitalization discharge codes through 2019 and linkage to inpatient and outpatient Medicare claims through 2018. RESULTS Of 10 946 participants (54.3% women; mean [SD] age, 57 [5.7] years), 93.0% had euthyroidism, 2.6% had subclinical hyperthyroidism, and 4.4% had subclinical hypothyroidism. During a median follow-up of 21 years (IQR, 13.0-27.3 years), there were 3556 incident fractures (167.1 per 10 000 person-years). The adjusted hazard ratios of fracture were 1.34 (95% CI, 1.09-1.65) for those with subclinical hyperthyroidism and 0.90 (95% CI, 0.77-1.05) for those with subclinical hypothyroidism compared with individuals with euthyroidism. Among those with normal free thyroxine levels, thyrotropin levels in the lower-than-normal range were significantly associated with higher fracture-related hospitalization risk; fracture risk was greater among individuals with thyrotropin concentrations below 0.56 mIU/L. CONCLUSIONS AND RELEVANCE This community-based cohort study suggests that subclinical hyperthyroidism was an independent risk factor associated with fracture. The increased risk for fracture among individuals with a thyrotropin level lower than 0.56 mIU/L highlights a potential role for more aggressive screening and monitoring of patients with subclinical hyperthyroidism to prevent bone mineral disease.
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Affiliation(s)
- Natalie R. Daya
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Anna Fretz
- Department of Medicine, University of California, San Francisco Medical Center, San Francisco
| | - Seth S. Martin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Division of Cardiology, Department of Medicine, Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Pamela L. Lutsey
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis
| | - Justin B. Echouffo-Tcheugui
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Elizabeth Selvin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Stephen P. Juraschek
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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Zhang F, Zhou GH, An Q, Yang J, Wang YH, Zhu JQ, Jin SN, Wen JF. Decreased gene expression of K ACh and K ATP channels in hyperthyroid rabbit atria. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2022; 15:145-151. [PMID: 35414842 PMCID: PMC8986473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 02/12/2022] [Indexed: 06/14/2023]
Abstract
Cardiac hypertrophy is a common myocardial structural abnormality which may cause heart failure. Many studies have shown that cardiac hypertrophy can be induced by hyperthyroidism. Ligand-gated potassium channels have been reported to be involved in various biological processes in the cardiovascular system, such as GPCR coupled KACh and metabolism sensor KATP channel. It is unclear whether the gene expression of KACh and KATP was altered in hyperthyroid rabbit atria. We aimed to investigate the expression of KACh and KATP genes in rabbit atria in our experimental model. We established an effective hyperthyroidism-induced cardiac hypertrophy animal model through an injection of T4. H&E staining and RT-PCR were used to observe the histomorphological damages and alteration of gene expression. The results showed that the heart weight, heart rate significantly increased in T4-treated rabbits. The systolic pressure increased from 115.60 mmHg to 152.6 mmHg in T4-treated rabbits. The expression of KACh and KATP genes was decreased in the atria of hyperthyroidism-induced cardiac hypertrophied rabbits. These findings indicated that the decreased gene expression of KACh and KATP may be related to hyperthyroidism-induced cardiac hypertrophy and atrial fibrillation.
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Affiliation(s)
- Feng Zhang
- School of Basic Medical Sciences, The Second Affiliated Hospital of Shandong First Medical University & Shandong Academy of Medical ScienceJinan 250117, Shandong, China
| | - Guang Hai Zhou
- School of Basic Medical Sciences, The Second Affiliated Hospital of Shandong First Medical University & Shandong Academy of Medical ScienceJinan 250117, Shandong, China
| | - Qi An
- School of Pharmacy, Shandong First Medical University & Shandong Academy of Medical SciencesTaian 271000, Shandong, China
| | - Jie Yang
- School of Pharmacy, Shandong First Medical University & Shandong Academy of Medical SciencesTaian 271000, Shandong, China
| | - Yu Hao Wang
- School of Pharmacy, Shandong First Medical University & Shandong Academy of Medical SciencesTaian 271000, Shandong, China
| | - Jia Quan Zhu
- School of Pharmacy, Shandong First Medical University & Shandong Academy of Medical SciencesTaian 271000, Shandong, China
| | - Song Nan Jin
- School of Pharmacy, Shandong First Medical University & Shandong Academy of Medical SciencesTaian 271000, Shandong, China
| | - Jin Fu Wen
- School of Basic Medical Sciences, The Second Affiliated Hospital of Shandong First Medical University & Shandong Academy of Medical ScienceJinan 250117, Shandong, China
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11
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Ogundipe VML, Groen AH, Hosper N, Nagle PWK, Hess J, Faber H, Jellema AL, Baanstra M, Links TP, Unger K, Plukker JTM, Coppes RP. Generation and Differentiation of Adult Tissue-Derived Human Thyroid Organoids. Stem Cell Reports 2021; 16:913-925. [PMID: 33711265 PMCID: PMC8072035 DOI: 10.1016/j.stemcr.2021.02.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 01/21/2023] Open
Abstract
Total thyroidectomy as part of thyroid cancer treatment results in hypothyroidism requiring lifelong daily thyroid hormone replacement. Unbalanced hormone levels result in persistent complaints such as fatigue, constipation, and weight increase. Therefore, we aimed to investigate a patient-derived thyroid organoid model with the potential to regenerate the thyroid gland. Murine and human thyroid-derived cells were cultured as organoids capable of self-renewal and which expressed proliferation and putative stem cell and thyroid characteristics, without a change in the expression of thyroid tumor-related genes. These organoids formed thyroid-tissue-resembling structures in culture. (Xeno-)transplantation of 600,000 dispersed organoid cells underneath the kidney capsule of a hypothyroid mouse model resulted in the generation of hormone-producing thyroid-resembling follicles. This study provides evidence that thyroid-lineage-specific cells can form organoids that are able to self-renew and differentiate into functional thyroid tissue. Subsequent (xeno-)transplantation of these thyroid organoids demonstrates a proof of principle for functional miniature gland formation.
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Affiliation(s)
- Vivian M L Ogundipe
- Department of Biomedical Sciences of Cells and Systems, Section of Molecular Cell Biology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands
| | - Andries H Groen
- Department of Biomedical Sciences of Cells and Systems, Section of Molecular Cell Biology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands; Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands
| | - Nynke Hosper
- Department of Biomedical Sciences of Cells and Systems, Section of Molecular Cell Biology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands
| | - Peter W K Nagle
- Department of Biomedical Sciences of Cells and Systems, Section of Molecular Cell Biology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands; Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands
| | - Julia Hess
- Research Unit Radiation Cytogenetics, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, Neuherberg 85764, Germany; Department of Radiation Oncology, University Hospital, LMU Munich, Munich 81377, Germany
| | - Hette Faber
- Department of Biomedical Sciences of Cells and Systems, Section of Molecular Cell Biology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands
| | - Anne L Jellema
- Department of Biomedical Sciences of Cells and Systems, Section of Molecular Cell Biology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands
| | - Mirjam Baanstra
- Department of Biomedical Sciences of Cells and Systems, Section of Molecular Cell Biology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands
| | - Thera P Links
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands
| | - Kristian Unger
- Research Unit Radiation Cytogenetics, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, Neuherberg 85764, Germany; Department of Radiation Oncology, University Hospital, LMU Munich, Munich 81377, Germany
| | - John T M Plukker
- Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands
| | - Rob P Coppes
- Department of Biomedical Sciences of Cells and Systems, Section of Molecular Cell Biology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands.
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12
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Nicolaisen P, Obling ML, Winther KH, Hansen S, Hermann AP, Hegedüs L, Bonnema SJ, Brix TH. Consequences of Hyperthyroidism and Its Treatment for Bone Microarchitecture Assessed by High-Resolution Peripheral Quantitative Computed Tomography. Thyroid 2021; 31:208-216. [PMID: 32703114 DOI: 10.1089/thy.2020.0084] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background: Hyperthyroidism is associated with bone mass reduction and increased fracture risk, but the effects on other important bone parameters have been sparsely examined. Therefore, we investigated bone microarchitecture and estimated bone strength by high-resolution peripheral quantitative computed tomography (HR-pQCT) in hyperthyroid patients at diagnosis and after being euthyroid for at least one year. Methods: Two approaches were used: (A) a case-control study comparing 61 hyperthyroid women with 61 euthyroid women matched for age and menopause status; (B) a follow-up study, in which 46 of the 61 women were re-examined after having been euthyroid for one year. HR-pQCT of the distal radius and tibia, and dual-energy X-ray absorptiometry (DXA) of the lumbar spine and the hip were performed. Results: In analysis A: In the radius, compared with the healthy controls, hyperthyroid patients had higher total area (16.9% ± 29.5%; p < 0.001), trabecular area (28.6% ± 45.7%; p < 0.001), and lower cortical area (-11.7% ± 23.2%; p < 0.001). Total volumetric bone mineral density (vBMD) (-13.9% ± 26.5%; p < 0.001), cortical vBMD (-5.8% ± 7.9%; p < 0.001), cortical thickness (-16.7% ± 26.0%; p < 0.001), and estimated bone strength (-6.6% ± 19.5%; p < 0.01) were lower. No significant differences were found in the tibia or in the DXA parameters. In analysis B: In the radius, significant improvements were observed in the cortical area (2.1% ± 4.6%; p < 0.01), cortical thickness (2.5% ± 5.1%; p < 0.001), and total vBMD (0.8% ± 3.0%; p < 0.05). Trabecular area decreased (-0.5% ± 1.0%; p < 0.01) and trabecular separation increased (2.0% ± 8.3%; p < 0.05). In the tibia, cortical area (3.6% ± 7.3%; p < 0.01) and cortical thickness (3.8% ± 7.6%; p < 0.01) increased, and trabecular area decreased (-0.5% ± 1.1%; p < 0.01). Areal BMD, measured by DXA, increased in the spine (1.1% ± 3.4%; p < 0.05) and in the hip (2.0% ± 3.8%; p < 0.01). Conclusions: Compared with the healthy control group, hyperthyroid women had lower vBMD, lower estimated bone strength, and compromised cortical microarchitecture in the radius. After restoration of euthyroidism, significant improvements in vBMD and cortical microarchitecture were observed, highlighting the importance of achieving and maintaining euthyroidism.
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Affiliation(s)
- Pia Nicolaisen
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | | | | | - Stinus Hansen
- Department of Medicine, Hospital of South West Jutland, Esbjerg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | | | - Laszlo Hegedüs
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Steen Joop Bonnema
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Thomas Heiberg Brix
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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13
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Alfieri F, Nyakatura JA, Amson E. Evolution of bone cortical compactness in slow arboreal mammals. Evolution 2020; 75:542-554. [PMID: 33314086 DOI: 10.1111/evo.14137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/16/2020] [Accepted: 11/22/2020] [Indexed: 01/26/2023]
Abstract
Convergent evolution is a major topic in evolutionary biology. Low bone cortical compactness (CC, a measure of porosity of cortical bone) in the extant genera of "tree sloths," has been linked to their convergent slow arboreal ecology. This proposed relationship of low CC with a slow arboreal lifestyle suggests potential convergent evolution of this trait in other slow arboreal mammals. Femoral and humeral CC were analyzed in "tree sloths," lorisids, koala, and extinct palaeopropithecids and Megaladapis, in comparison to closely related but ecologically distinct taxa, in a phylogenetic framework. Low CC in "tree sloths" is unparalleled by any analyzed clade and the high CC in extinct sloths suggests the recent convergence of low CC in "tree sloths." A tendency for low CC was found in Palaeopropithecus and Megaladapis. However, lorisids and the koala yielded unexpected CC patterns, preventing the recognition of a straightforward convergence of low CC in slow arboreal mammals. This study uncovers a complex relationship between CC and convergent evolution of slow arboreality, highlighting the multifactorial specificity of bone microstructure.
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Affiliation(s)
- Fabio Alfieri
- Institut für Biologie, Humboldt Universität zu Berlin, Berlin, Germany.,Museum für Naturkunde, Leibniz-Institut für Evolutions- und Biodiversitätsforschung, Berlin, Germany
| | - John A Nyakatura
- Institut für Biologie, Humboldt Universität zu Berlin, Berlin, Germany
| | - Eli Amson
- Museum für Naturkunde, Leibniz-Institut für Evolutions- und Biodiversitätsforschung, Berlin, Germany
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14
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Fitzgerald SP, Bean NG, Falhammar H, Tuke J. Clinical Parameters Are More Likely to Be Associated with Thyroid Hormone Levels than with Thyrotropin Levels: A Systematic Review and Meta-Analysis. Thyroid 2020; 30:1695-1709. [PMID: 32349628 PMCID: PMC7757573 DOI: 10.1089/thy.2019.0535] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: Though the functional states of other endocrine systems are not defined on the basis of levels of controlling hormones, the assessment of thyroid function is based on levels of the controlling hormone thyrotropin (TSH). We, therefore, addressed the question as to whether levels of thyroid hormones [free thyroxine (fT4), total triiodothyronine (TT3)/free triiodothyronine (fT3)], or TSH levels, within and beyond the reference ranges, provide the better guide to the range of clinical parameters associated with thyroid status. Methods: A PubMed/MEDLINE search of studies up to October 2019, examining associations of levels of thyroid hormones and TSH, taken simultaneously in the same individuals, with clinical parameters was performed. We analyzed atrial fibrillation, other cardiac parameters, osteoporosis and fracture, cancer, dementia, frailty, mortality, features of the metabolic syndrome, and pregnancy outcomes. Studies were assessed for quality by using a modified Newcastle-Ottawa score. Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed. A meta-analysis of the associations was performed to determine the relative likelihood of fT4, TT3/fT3, and TSH levels that are associated with the clinical parameters. Results: We identified 58 suitable articles and a total of 1880 associations. In general, clinical parameters were associated with thyroid hormone levels significantly more often than with TSH levels-the converse was not true for any of the clinical parameters. In the 1880 considered associations, fT4 levels were significantly associated with clinical parameters in 50% of analyses. The respective frequencies for TT3/fT3 and TSH levels were 53% and 23% (p < 0.0001 for both fT4 and TT3/fT3 vs. TSH). The fT4 and TT3/fT3 levels were comparably associated with clinical parameters (p = 0.71). More sophisticated statistical analyses, however, indicated that the associations with TT3/fT3 were not as robust as the associations with fT4. Conclusions: Thyroid hormones levels, and in particular fT4 levels, seem to have stronger associations with clinical parameters than do TSH levels. Associations of clinical parameters with TSH levels can be explained by the strong negative population correlation between thyroid hormones and TSH. Clinical and research components of thyroidology currently based on the measurement of the thyroid state by reference to TSH levels warrant reconsideration.
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Affiliation(s)
- Stephen P. Fitzgerald
- Department of General Medicine and Royal Adelaide Hospital, Adelaide, South Australia
- Department of Endocrinology, Royal Adelaide Hospital, Adelaide, South Australia
- School of Medicine, University of Adelaide, Adelaide, South Australia
| | - Nigel G. Bean
- School of Mathematical Sciences, University of Adelaide, Adelaide, South Australia
- ARC Centre of Excellence for Mathematical and Statistical Frontiers, University of Adelaide, Adelaide, South Australia
| | - Henrik Falhammar
- Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Wellbeing and Chronic Preventable Diseases Division, Menzies School of Health Research and Royal Darwin Hospital, Tiwi, Australia
| | - Jono Tuke
- School of Mathematical Sciences, University of Adelaide, Adelaide, South Australia
- ARC Centre of Excellence for Mathematical and Statistical Frontiers, University of Adelaide, Adelaide, South Australia
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15
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Mihaljević O, Živančević-Simonović S, Lučić-Tomić A, Živković I, Minić R, Mijatović-Teodorović L, Jovanović Z, Anđelković M, Stanojević-Pirković M. The association of circulating sclerostin level with markers of bone metabolism in patients with thyroid dysfunction. J Med Biochem 2020; 39:436-443. [PMID: 33312059 DOI: 10.5937/jomb0-24943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 12/29/2019] [Indexed: 01/23/2023] Open
Abstract
Background The aim of this study was to compare serum sclerostin concentrations in patients with thyroid dysfunction with euthyroid control subjects and to assess the relationship between sclerostin and markers of bone metabolism (osteocalcin and beta-cross-laps). Methods The study included 30 patients with thyroid dysfunction (hypothyroidism, hyperthyroidism and subclinical hyperthyroidism) and ten euthyroid controls. Free thyroxine (FT4) was measured by radioimmunoassay, while thyroid stimulating hormone (TSH) concentration was determined immunoradiometrically. We used an ELISA kit to determine the sclerostin level. The electrochemiluminescence method was applied for measuring the bone markers. Results Sclerostin levels were significantly lower in hypothyroid patients (p=0.009) and significantly elevated in hyperthyroid patients (p=0.008) compared to control values. Hyperthyroid patients also had higher sclerostin than patients with subclinical hyperthyroidism (p=0.013). Sclerostin concentrations were negatively correlated with TSH levels (r=-0.746, p<0.001), but positively with FT4 (r=0.696, p < 0.001). Moreover, sclerostin was positively associated with osteocalcin (r=0.605, p=0.005) and beta-cross-laps levels (r=0.573, p=0.008) in all thyroid patients. Conclusions Serum sclerostin is significantly affected in subjects with thyroid dysfunction. Both sclerostin and thyroid status affect bone homeostasis, which is reflected through the significant correlations with osteocalcin and beta-cross-laps.
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Affiliation(s)
- Olgica Mihaljević
- University of Kragujevac, Faculty of Medical Sciences, Department of Pathophysiology, Kragujevac
| | | | - Aleksandra Lučić-Tomić
- University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac
| | - Irena Živković
- Institute of Virology, Vaccines and Sera, Torlak, Department of Scientific Research, Belgrade
| | - Rajna Minić
- Institute of Virology, Vaccines and Sera, Torlak, Department of Scientific Research, Belgrade
| | | | - Zorica Jovanović
- University of Kragujevac, Faculty of Medical Sciences, Department of Pathophysiology, Kragujevac
| | - Marija Anđelković
- University of Kragujevac, Faculty of Medical Sciences, Department of Biochemistry, Kragujevac
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16
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Kang YE, Kang YM, Park B, Shong M, Yi HS. Type 2 deiodinase Thr92Ala polymorphism is associated with a reduction in bone mineral density: A community-based korean genome and epidemiology study. Clin Endocrinol (Oxf) 2020; 93:238-247. [PMID: 32324283 DOI: 10.1111/cen.14206] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 03/09/2020] [Accepted: 04/20/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Type 2 deiodinase (DIO2)-mediated thyroid hormone synthesis stimulates osteoblast activity and increases the expression of osteoblast differentiation markers, but there are no large cohort studies to identify the role of the DIO2 polymorphism in bone mineral density in humans. METHODS To investigate the hypothesis that individuals with the DIO2 gene polymorphism are susceptible to osteoporosis, we assessed the polymorphism of the DIO2 gene in 7,524 Koreans drawn from the large-scale Ansan-Anseong cohort of the Korean Genome and Epidemiology Study. All of the participants underwent genotyping of the DIO2 Thr92Ala polymorphism (rs225014). RESULTS A total of 6,022 participants were recruited; 1991 (33.0%) were homozygous for the Thr allele, 2,967 (49.3%) were heterozygous (Thr/Ala), and 1064 (17.7%) were homozygous for the Ala allele. The effects of the DIO2 Thr92Ala polymorphism on axial speed of sound (SOS) and the T-score in the tibia and radius were assessed, with age, gender, oestrogen status, body mass index (BMI), serum calcium, 25-hydroxyvitamin D, and parathyroid hormone (PTH) included as covariables. Female subjects carrying the DIO2 Thr92Ala polymorphism had significantly lower SOS and T-scores than control participants. Cox regression analysis revealed a significant relationship between the DIO2 polymorphism and diagnosis of osteoporosis in female participants. CONCLUSION DIO2 Thr92Ala polymorphism is associated with decreased SOS and T-scores in the tibia of female subjects independent of other clinical parameters, where this indicates a potential functional role of DIO2 in the maintenance of bone mineral density.
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Affiliation(s)
- Yea Eun Kang
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University School of Medicine, Daejeon, Korea
| | - Young Mi Kang
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University School of Medicine, Daejeon, Korea
| | - Boyoung Park
- Department of Medicine, College of Medicine, Hanyang University, Seoul, Korea
| | - Minho Shong
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University School of Medicine, Daejeon, Korea
- Department of Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
| | - Hyon-Seung Yi
- Research Center for Endocrine and Metabolic Diseases, Chungnam National University School of Medicine, Daejeon, Korea
- Department of Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
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17
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Kirk B, Al Saedi A, Duque G. Osteosarcopenia: A case of geroscience. Aging Med (Milton) 2019; 2:147-156. [PMID: 31942528 PMCID: PMC6880711 DOI: 10.1002/agm2.12080] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 08/19/2019] [Indexed: 12/12/2022] Open
Abstract
Many older persons lose their mobility and independence due to multiple diseases occurring simultaneously. Geroscience is aimed at developing innovative approaches to better identify relationships among the biological processes of aging. Osteoporosis and sarcopenia are two of the most prevalent chronic diseases in older people, with both conditions sharing overlapping risk factors and pathogenesis. When occurring together, these diseases form a geriatric syndrome termed "osteosarcopenia," which increases the risk of frailty, hospitalizations, and death. Findings from basic and clinical sciences aiming to understand osteosarcopenia have provided evidence of this syndrome as a case of geroscience. Genetic, endocrine, and mechanical stimuli, in addition to fat infiltration, sedentarism, and nutritional deficiencies, affect muscle and bone homeostasis to characterize this syndrome. However, research is in its infancy regarding accurate diagnostic markers and effective treatments with dual effects on muscle and bone. To date, resistance exercise remains the most promising strategy to increase muscle and bone mass, while sufficient quantities of protein, vitamin D, calcium, and creatine may preserve these tissues with aging. More recent findings, from rodent models, suggest treating ectopic fat in muscle and bone marrow as a possible avenue to curb osteosarcopenia, although this needs testing in human clinical trials.
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Affiliation(s)
- Ben Kirk
- Department of MedicineWestern HealthMelbourne Medical SchoolUniversity of MelbourneMelbourneVic.Australia
- Australian Institute for Musculoskeletal Science (AIMSS)University of Melbourne and Western HealthMelbourneVic.Australia
| | - Ahmed Al Saedi
- Department of MedicineWestern HealthMelbourne Medical SchoolUniversity of MelbourneMelbourneVic.Australia
- Australian Institute for Musculoskeletal Science (AIMSS)University of Melbourne and Western HealthMelbourneVic.Australia
| | - Gustavo Duque
- Department of MedicineWestern HealthMelbourne Medical SchoolUniversity of MelbourneMelbourneVic.Australia
- Australian Institute for Musculoskeletal Science (AIMSS)University of Melbourne and Western HealthMelbourneVic.Australia
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18
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Papaleontiou M, Banerjee M, Reyes-Gastelum D, Hawley ST, Haymart MR. Risk of Osteoporosis and Fractures in Patients with Thyroid Cancer: A Case-Control Study in U.S. Veterans. Oncologist 2019; 24:1166-1173. [PMID: 31164453 PMCID: PMC6738319 DOI: 10.1634/theoncologist.2019-0234] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 04/26/2019] [Accepted: 05/01/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Data on osteoporosis and fractures in patients with thyroid cancer, especially men, are conflicting. Our objective was to determine osteoporosis and fracture risk in U.S. veterans with thyroid cancer. MATERIALS AND METHODS This is a case-control study using the Veterans Health Administration Corporate Data Warehouse (2004-2013). Patients with thyroid cancer (n = 10,370) and controls (n = 10,370) were matched by age, sex, weight, and steroid use. Generalized linear mixed-effects regression model was used to compare the two groups in terms of osteoporosis and fracture risk. Next, subgroup analysis of the patients with thyroid cancer using longitudinal thyroid-stimulating hormone (TSH) was performed to determine its effect on risk of osteoporosis and fractures. Other covariates included patient age, sex, median household income, comorbidities, and steroid and androgen use. RESULTS Compared with controls, osteoporosis, but not fractures, was more frequent in patients with thyroid cancer (7.3% vs. 5.3%; odds ratio [OR], 1.33; 95% confidence interval [CI], 1.18-1.49) when controlling for median household income, Charlson/Deyo comorbidity score, and androgen use. Subgroup analysis of patients with thyroid cancer demonstrated that lower TSH (OR, 0.93; 95% CI, 0.90-0.97), female sex (OR, 4.24; 95% CI, 3.53-5.10), older age (e.g., ≥85 years: OR, 17.18; 95% CI, 11.12-26.54 compared with <50 years), and androgen use (OR, 1.63; 95% CI, 1.18-2.23) were associated with osteoporosis. Serum TSH was not associated with fractures (OR, 1.01; 95% CI, 0.96-1.07). CONCLUSION Osteoporosis, but not fractures, was more common in U.S. veterans with thyroid cancer than controls. Multiple factors may be contributory, with low TSH playing a small role. IMPLICATIONS FOR PRACTICE Data on osteoporosis and fragility fractures in patients with thyroid cancer, especially in men, are limited and conflicting. Because of excellent survival rates, the number of thyroid cancer survivors is growing and more individuals may experience long-term effects from the cancer itself and its treatments, such as osteoporosis and fractures. The present study offers unique insight on the risk for osteoporosis and fractures in a largely male thyroid cancer cohort. Physicians who participate in the long-term care of patients with thyroid cancer should take into consideration a variety of factors in addition to TSH level when considering risk for osteoporosis.
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Affiliation(s)
- Maria Papaleontiou
- Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, Michigan, USA
| | - Mousumi Banerjee
- School of Public Health, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - David Reyes-Gastelum
- Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, Michigan, USA
| | - Sarah T Hawley
- Division of General Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Megan R Haymart
- Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, Michigan, USA
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19
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Montañez‐Rivera I, Nyakatura JA, Amson E. Bone cortical compactness in 'tree sloths' reflects convergent evolution. J Anat 2018; 233:580-591. [PMID: 30117161 PMCID: PMC6183012 DOI: 10.1111/joa.12873] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2018] [Indexed: 01/15/2023] Open
Abstract
Bone remodeling, one of the main processes that regulate bone microstructure, consists of bone resorption followed by the deposition of secondary bone at the same location. Remodeling intensity varies among taxa, but a characteristically compact cortex is ubiquitous in the long bones of mature terrestrial mammals. A previous analysis found that cortical bone in a few 'tree sloth' (Bradypus and Choloepus) specimens is heavily remodeled and characterized by numerous immature secondary osteons, suggesting that these animals were remodeling their bones at high rate until late in their ontogeny. This study aims at testing if this remodeling is generally present in 'tree sloths', using a quantitative analysis of the humeral cortical compactness (CC) among xenarthrans. The results of the investigation of humeral diaphyseal cross-sections of 26 specimens belonging to 10 xenarthran species including specimens from both extinct and extant species indicate that in 'tree sloths' the CC is significantly lower than in the other sampled xenarthrans. No significant difference was found between the CC of the two genera of 'tree sloths'. Our results are consistent with the hypothesis that the cortical bone of 'tree sloths' in general undergoes intense and balanced remodeling that is maintained until late (possibly throughout) in their ontogeny. In the light of xenarthran phylogeny, low CC represents another convergence between the long-separated 'tree sloth' lineages. Although the exact structural and/or functional demands that are associated with this trait are hitherto unknown, several hypotheses are suggested here, including a relationship to their relatively low metabolism and to the mechanical demands imposed upon the bones by the suspensory posture and locomotion, which was independently acquired by the two genera of 'tree sloths'.
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Affiliation(s)
- Irene Montañez‐Rivera
- AG Morphologie und FormengeschichteInstitut für BiologieHumboldt UniversitätBerlinGermany
| | - John A. Nyakatura
- AG Morphologie und FormengeschichteInstitut für BiologieHumboldt UniversitätBerlinGermany
- Bild Wissen Gestaltung. Ein interdisziplinäres LaborHumboldt UniversitätBerlinGermany
| | - Eli Amson
- AG Morphologie und FormengeschichteInstitut für BiologieHumboldt UniversitätBerlinGermany
- Bild Wissen Gestaltung. Ein interdisziplinäres LaborHumboldt UniversitätBerlinGermany
- Museum für NaturkundeLeibniz‐Institut für Evolutions‐ und BiodiversitätsforschungBerlinGermany
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Chawla J, Sharma N, Arora D, Arora M, Shukla L. Bone densitometry status and its associated factors in peri and post menopausal females: A cross sectional study from a tertiary care centre in India. Taiwan J Obstet Gynecol 2018; 57:100-105. [PMID: 29458876 DOI: 10.1016/j.tjog.2017.12.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2017] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Osteoporosis is a skeletal disorder characterized by diminished bone strength that increases the risk of fracture at instances of trivial trauma. Asians have a lower bone mass than the west. The present study was designed to add data from India on women above the age of 40 years with respect to low bone mineral density (BMD) and its associated high risk factors. MATERIALS AND METHODS After a written informed consent, a detailed history was taken. Basal metabolic index was recorded, and biochemical and endocrine tests were done, followed by dual X ray absorptiometry scan. RESULTS Average age of the study population was 46.54 years and BMI 26.58. The prevalence of osteopenia in the study was 36%, and that of osteoporosis, 4%; the overall prevalence of low BMD being 40%. Proportion of women with low BMD increased with advancing age and menopausal status. On endocrine evaluation, 53.44% cases with insufficient vitamin D, 62.5% with hyperparathyroidism, 100% with hypothyroidism, 75% with hyperthyroidism suffered from low BMD. Among chronic diseases, 75% women with diabetes, 33.3% with hypertension, 25% with deranged liver function and 50% with rheumatoid arthritis were found to have low BMD. 46.75% women with sun exposure less than one hour daily had poor bone mineralization. The proportion of women with normal BMD decreased from 84.09% to 43.33% with decrease in daily physical work. On logistic regression analysis, insufficient serum vitamin D concentrations, less physical work and inadequate sun exposure were found to be significantly associated with low BMD. CONCLUSION Low BMD is not a disorder confined to postmenopausal women alone. It is widely prevalent in women above 40 years of age. Screening women above 40 in the absence of any high risk factors has the potential of nipping this silent killer in the bud.
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Affiliation(s)
- Jaya Chawla
- Department of OB GYN, PGIMER & Dr. RML Hospital, New Delhi, India.
| | - Neena Sharma
- Department of OB GYN, ACMS & BHDC, New Delhi, India
| | - Devendra Arora
- Department of OB GYN, Command Hospital, (SC), Pune, India
| | - Manisha Arora
- Department of Community Medicine, ACMS & BHDC, New Delhi, India
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Siderova M, Hristozov K, Tsukeva A. TSH-receptor antibodies may prevent bone loss in pre- and postmenopausal women with Graves' disease and Graves' orbitopathy. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2018; 62:221-226. [PMID: 29768627 PMCID: PMC10118993 DOI: 10.20945/2359-3997000000027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 12/23/2016] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Thyrotoxicosis is established risk factor for osteoporosis due to increased bone turnover. Glucocorticoids often administered for Graves' orbitopathy (GO) have additional negative effect on bone mineral density (BMD). Our aim was to examine the influence of thyroid hormones, TSH, TSH-receptor antibodies (TRAb) and glucocorticoid treatment on bone in women with Graves' thyrotoxicosis and Graves' orbitopathy (GO). SUBJECTS AND METHODS Forty seven women with Graves' disease, mean age 55.6 ± 12.8 (23 women with thyrotoxicosis and 24 hyperthyroid with concomitant GO and glucocorticoid therapy) and 40 age-matched healthy female controls were enrolled in the study. We analyzed clinical features, TSH, FT4, FT3, TRAb, TPO antibodies. BMD of lumbar spine and hip was measured by DEXA and 10-year fracture risk was calculated with FRAX tool. RESULTS The study showed significantly lower spine and femoral BMD (g/cm2) in patients with and without GO compared to controls, as well as significantly higher fracture risk. Comparison between hyperthyroid patients without and with orbitopathy found out significantly lower spine BMD in the first group (p = 0.0049). Negative correlations between FT3 and femoral neck BMD (p = 0.0001), between FT4 and BMD (p = 0.049) and positive between TSH and BMD (p = 0.0001), TRAb and BMD (p = 0.026) were observed. Fracture risk for major fractures and TRAb were negatively associated (p = 0.05). We found negative correlation of BMD to duration of thyrotoxicosis and cumulative steroid dose. CONCLUSIONS Our results confirm the negative effect of hyperthyroid status on BMD. TRAb, often in high titers in patients with GO, may have protective role for the bone, but further research is needed.
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Ale AO, Ogbera AO, Ebili HO, Adeyemo OL, Afe TO. Prevalence, Predictive Factors, and Characteristics of Osteoporosis in Hyperthyroid Patients. Int J Endocrinol 2018; 2018:3540256. [PMID: 29849614 PMCID: PMC5907485 DOI: 10.1155/2018/3540256] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 02/14/2018] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE The osteoporosis in thyroid disorder has the lowest report especially in sub-Saharan Africa. This study aims to determine the prevalence, predictive factors, and characteristics of osteoporosis in hyperthyroid patients. METHOD Forty (40) hyperthyroid patients and healthy controls ages 21-50 years were recruited in this study. Questionnaires were administered to capture bio- and clinical data. Biochemical tests included blood, thyroid functions, intact parathyroid hormone, corrected calcium, and 25-hydroxyvitamin D tests. Bone mineral density (BMD) was also evaluated. Data were analyzed using the SPSS 21. A p value < 0.05 was regarded as significant. RESULTS Osteoporosis was observed in 18 (45%) of study subjects, 13 (72.2%) females and 5 (27.8%) males, respectively. The BMD of the hyperthyroid patients had a negative correlation with free triiodothyronine, FT3 (r = -0.49, p = 0.005), FT4 (r = -0.33, p = 0.009), corrected calcium (r = -0.31, p = 0.039), alkaline phosphatase (r = -0.53, p < 0.001), and osteocalcin (r = -0.61, p < 0.001). Conversely, a positive association with thyroid-stimulating hormone (TSH) (r = 0.54, p < 0.001) was observed. Multiple regression showed osteocalcin (p < 0.001) and TSH (p = 0.015) as independent predictors of osteoporosis. CONCLUSION Thyrotoxicosis is a risk factor for osteoporosis occurrence, and we recommend routine screening for this bone disease in persons over 20 years old with this disorder.
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Affiliation(s)
- Ayotunde O. Ale
- Department of Medicine, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
| | - Anthonia O. Ogbera
- Department of Medicine, College of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria
| | - Henry O. Ebili
- Department of Morbid Anatomy and Histopathology, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
| | - Olusola L. Adeyemo
- Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Ago-Iwoye, Ogun State, Nigeria
| | - Taiwo O. Afe
- Department of Medicine, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
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Centanni M, Benvenga S, Sachmechi I. Diagnosis and management of treatment-refractory hypothyroidism: an expert consensus report. J Endocrinol Invest 2017; 40:1289-1301. [PMID: 28695483 PMCID: PMC5680379 DOI: 10.1007/s40618-017-0706-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 06/01/2017] [Indexed: 12/17/2022]
Abstract
There is a frequently encountered subset of hypothyroid patients who are refractory to standard thyroid hormone replacement treatment and require unexpectedly high doses of levothyroxine. In addition to clinical situations where hypothyroid patients are non-compliant, or where there is the possibility of excipient-induced disease exacerbation (gluten/celiac disease), therapeutic failure may be due to impaired absorption of the administered drug. The common approach to managing patients with unusual thyroxine needs is to escalate the dose of levothyroxine until targeted TSH levels are achieved. This approach can increase the risk for prolonged exposure to supratherapeutic doses of levothyroxine, which increase the chances of adverse outcomes. Repeated adjustments of levothyroxine can also escalate the costs of treatment, as frequent office visits and laboratory tests are required to determine and maintain the desired dose. Clinicians should take a systematic approach to managing patients whom they suspect of having treatment-refractory hypothyroidism. This may include searching for, and adjusting, occult medical conditions and/or other factors that may affect the absorption of levothyroxine, before up-titrating the dose of traditional levothyroxine therapy. Depending on the underlying pathology, another approach that may be considered is to try alternative formulations of levothyroxine that are less susceptible to intolerance issues related to excipients, or, in some cases, to malabsorption. The early discovery of these factors via a thoughtful patient work-up may avoid unnecessary thyroid medication adjustments and their consequences for both patients and clinicians.
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Affiliation(s)
- M. Centanni
- Section of Endocrinology, Department of Medico-surgical Services and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - S. Benvenga
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
- Interdepartmental Program of Molecular and Clinical Endocrinology and Women’s Endocrine Health, A.O.U. Policlinico G Martino, Messina, Italy
| | - I. Sachmechi
- Division of Endocrinology, Queens Hospital Center, Icahn School of Medicine, Jamaica, NY USA
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Fujita K, Tokuda H, Kainuma S, Kuroyanagi G, Yamamoto N, Matsushima-Nishiwaki R, Harada A, Kozawa O, Otsuka T. Resveratrol suppresses thyroid hormone‑induced osteocalcin synthesis in osteoblasts. Mol Med Rep 2017; 16:2881-2886. [PMID: 28677796 DOI: 10.3892/mmr.2017.6872] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 04/04/2017] [Indexed: 11/06/2022] Open
Abstract
Resveratrol, a polyphenolic compound that is present in grape skins, berries and red wine, may be beneficial for human health through its anti‑inflammatory and anti‑oxidant effects. It has been previously demonstrated that resveratrol exerts its biological effects primarily via sirtuin 1 (SIRT1) activation. We previously reported that triiodothyronine (T3) induces osteocalcin synthesis in osteoblast‑like MC3T3‑E1 cells, and that p38 mitogen‑activated protein (MAP) kinase mediates the T3‑stimulated synthesis of osteocalcin. The present study investigated the effect of resveratrol on T3‑induced osteocalcin synthesis and its underlying mechanism in MC3T3‑E1 cells. Cultured cells were stimulated with T3, and osteocalcin release from MC3T3‑E1 cells was measured by ELISA and phosphorylation of p38 MAP kinase was analyzed by western blotting. Resveratrol significantly suppressed the release of osteocalcin stimulated by T3, and SRT1720, a SIRT1 activator, significantly reduced T3‑induced osteocalcin release. The expression level of osteocalcin mRNA stimulated by T3 was significantly attenuated by resveratrol and T3‑induced transactivation activity of the thyroid hormone‑responsive element was significantly diminished by resveratrol. However, only limited effects of resveratrol on the T3‑induced phosphorylation of p38 MAP kinase were observed. The results of the present study demonstrated that resveratrol suppresses T3‑stimulated osteocalcin synthesis at a point upstream of transcription in osteoblasts, and that the inhibitory effect of resveratrol is mediated, at least partially, through SIRT1 activation. These results indicate that there may be a novel role for the polyphenol in the modulation of bone metabolism.
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Affiliation(s)
- Kazuhiko Fujita
- Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467‑8601, Japan
| | - Haruhiko Tokuda
- Department of Pharmacology, Gifu University Graduate School of Medicine, Gifu 501‑1194, Japan
| | - Shingo Kainuma
- Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467‑8601, Japan
| | - Gen Kuroyanagi
- Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467‑8601, Japan
| | - Naohiro Yamamoto
- Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467‑8601, Japan
| | | | - Atsushi Harada
- Department of Orthopedic Surgery, National Center for Geriatrics and Gerontology, Obu, Aichi 474‑8511, Japan
| | - Osamu Kozawa
- Department of Pharmacology, Gifu University Graduate School of Medicine, Gifu 501‑1194, Japan
| | - Takanobu Otsuka
- Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467‑8601, Japan
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Mustonen AMJ, Finnilä MAJ, Puukka KS, Jämsä TJ, Saarakkala S, Tuukkanen JK, Nieminen TP. Raccoon dog model shows preservation of bone during prolonged catabolism and reduced physical activity. ACTA ACUST UNITED AC 2017; 220:2196-2202. [PMID: 28373598 DOI: 10.1242/jeb.135475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 03/27/2017] [Indexed: 11/20/2022]
Abstract
The raccoon dog (Nyctereutes procyonoides) is a promising animal model capable of preventing disuse-induced osteoporosis. Previous data suggest that this species resembles bears in the preservation of bone mass and biomechanical properties during prolonged passivity and catabolism. This longitudinal study examined the osteological properties of tibiae in farm-bred raccoon dogs that were either fed or fasted (n=6 per group) for a 10 week period. Peripheral quantitative computed tomography was utilized and plasma markers of bone turnover measured before fasting and at 9 weeks followed by mechanical testing (three-point bending), micro-computed tomography and Fourier transform infrared imaging at 10 weeks. Passive wintering with prolonged catabolism (body mass loss 32%) had no significant effects on bone mineralization, porosity or strength. The concentration of C-terminal telopeptide of type I collagen, indicative of bone resorption, increased in the plasma of the fasted raccoon dogs, while the bone formation markers were unchanged. The levels of 25-hydroxyvitamin D were reduced in the fasted animals. Based on these data, the preservation of bone in wintering raccoon dogs shares characteristics with that of bears with no apparent decrease in the formation of bone but increased resorption. To conclude, raccoon dogs were able to minimize bone loss during a 10 week period of catabolism and passivity.
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Affiliation(s)
- Anne-Mari J Mustonen
- University of Eastern Finland, Faculty of Health Sciences, School of Medicine, Institute of Biomedicine/Anatomy, PO Box 1627, Kuopio FI-70211, Finland .,University of Eastern Finland, Faculty of Science and Forestry, Department of Environmental and Biological Sciences, PO Box 111, Joensuu FI-80101, Finland
| | - Mikko A J Finnilä
- University of Oulu, Faculty of Medicine, Research Unit of Medical Imaging, Physics and Technology, PO Box 5000, Oulu FI-90014, Finland.,University of Eastern Finland, Faculty of Science and Forestry, Department of Applied Physics, PO Box 1627, Kuopio FI-70211, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 5000, Oulu FI-90014, Finland
| | - Katri S Puukka
- NordLab Oulu, Oulu University Hospital, PO Box 500, Oulu FI-90029, OYS, Finland.,University of Oulu, Faculty of Medicine, Department of Clinical Chemistry, PO Box 8000, Oulu FI-90014, Finland
| | - Timo J Jämsä
- University of Oulu, Faculty of Medicine, Research Unit of Medical Imaging, Physics and Technology, PO Box 5000, Oulu FI-90014, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 5000, Oulu FI-90014, Finland.,Department of Diagnostic Radiology, Oulu University Hospital, PO Box 50, Oulu FI-90029, Finland
| | - Simo Saarakkala
- University of Oulu, Faculty of Medicine, Research Unit of Medical Imaging, Physics and Technology, PO Box 5000, Oulu FI-90014, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 5000, Oulu FI-90014, Finland.,Department of Diagnostic Radiology, Oulu University Hospital, PO Box 50, Oulu FI-90029, Finland
| | - Juha K Tuukkanen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 5000, Oulu FI-90014, Finland.,University of Oulu, Faculty of Medicine, Research Group of Cancer Research and Translational Medicine, PO Box 5000, Oulu FI-90014, Finland
| | - T Petteri Nieminen
- University of Eastern Finland, Faculty of Health Sciences, School of Medicine, Institute of Biomedicine/Anatomy, PO Box 1627, Kuopio FI-70211, Finland.,University of Eastern Finland, Faculty of Science and Forestry, Department of Environmental and Biological Sciences, PO Box 111, Joensuu FI-80101, Finland
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Chen K, Xie Y, Zhao L, Mo Z. Hyperthyroidism-associated hypercalcemic crisis: A case report and review of the literature. Medicine (Baltimore) 2017; 96:e6017. [PMID: 28121960 PMCID: PMC5287984 DOI: 10.1097/md.0000000000006017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 01/05/2017] [Accepted: 01/09/2017] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Hyperthyroidism is one of the major clinical causes of hypercalcaemia, however, hyperthyroidism-related hypercalcemic crisis is rare, only 1 case have been reported. The potential mechanisms are still not too clear. It may be related that thyroid hormone stimulate bone turnover, elevate serum calcium, increase urinary and fecal calcium excretion. PATIENT CONCERNS A 58-year-old female patient was found to have Graves' disease, a marked elevated serum calcium level (adjusted serum calcium: 3.74 mmol/L), and reduced parathyroid hormone level. DIAGNOSES She was diagnosed as hyperthyroidism-associated hypercalcemic crisis. INTERVENTIONS Treatment with methimazole to correct the hyperthyroidism and treatment of the patient's hypercalcaemia was achieved by physiological saline, salmon calcitonin and furosemide. OUTCOMES After treatment for hypercalcaemia and hyperthyroidism, her symptoms and serum calcium levels quickly returned to normal. LESSONS hyperthyroid-associated hypercalcaemia crisis is rare, however, the diagnosis should pay attention to screening for other diseases caused by hypercalcemia. Timely treatment of hypercalcaemia is a critical step for rapidly control of symptoms, and treatment of hyperthyroidism is beneficial to relief the symptoms and maintain the blood calcium level.
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Konca Degertekin C, Turhan Iyidir O, Aktas Yılmaz B, Elbeg S, Pasaoglu OT, Pasaoglu H, Cakır N, Arslan M. RANKL/Osteoprotegerin System and Bone Turnover in Hashimoto Thyroiditis. Calcif Tissue Int 2016; 99:365-72. [PMID: 27328677 DOI: 10.1007/s00223-016-0163-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 06/09/2016] [Indexed: 11/29/2022]
Abstract
Hypothyroidism is associated with changes in bone metabolism. The impact of hypothyroidism and the associated autoimmunity on the mediators of bone turnover in Hashimoto's thyroiditis (HT) is not known. In this study, we assessed the levels of OPG, RANKL, and IL-6 along with markers of bone formation as osteocalcin (OC) and markers of bone resorption as type 1 collagen C telopeptide (CTX) and tartrate-resistant acid phosphatase isoform 5b (TRAcP 5b) in 30 hypothyroid and 30 euthyroid premenopausal HT patients and 20 healthy premenopausal controls. We found that TRAcP 5b (p = 0.006), CTX (p = 0.01), OC (p = 0.017), and IL-6 (p < 0.001) levels were lower in the hypothyroid group compared to euthyroid HT patients and controls. OPG levels were higher (p < 0.001) and RANKL levels were lower (p = 0.021) in hypothyroid and euthyroid HT patients compared to controls. TSH was negatively correlated with IL-6 (rho = -0.434, p < 0.001), OC (rho = -0.313, p = 0.006), TRAcP 5b (rho = -0.335, p = 0.003), and positively correlated with OPG (rho = 0.248, p = 0.029). RANKL/OPG ratio was independently associated with the presence of HT. In conclusion, bone turnover is slowed down by hypothyroidism in premenopausal patients with HT. Thyroid autoimmunity might have a unique impact on OPG/RANKL levels apart from the resultant hypothyroidism.
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Affiliation(s)
- Ceyla Konca Degertekin
- Department of Endocrinology and Metabolism, Endokrinoloji ve Metabolizma BD, Gazi University Faculty of Medicine, Gazi Üniversitesi Hastanesi, 06100, Beşevler, Ankara, Turkey.
| | - Ozlem Turhan Iyidir
- Department of Endocrinology and Metabolism, Endokrinoloji ve Metabolizma BD, Gazi University Faculty of Medicine, Gazi Üniversitesi Hastanesi, 06100, Beşevler, Ankara, Turkey
| | - Banu Aktas Yılmaz
- Department of Endocrinology and Metabolism, Endokrinoloji ve Metabolizma BD, Gazi University Faculty of Medicine, Gazi Üniversitesi Hastanesi, 06100, Beşevler, Ankara, Turkey
| | - Sehri Elbeg
- Department of Biochemistry, Biyokimya AD, Gazi University Faculty of Medicine, Gazi Üniversitesi Hastanesi, 06100, Beşevler, Ankara, Turkey
| | - Ozge Tugce Pasaoglu
- Department of Biochemistry, Biyokimya AD, Gazi University Faculty of Medicine, Gazi Üniversitesi Hastanesi, 06100, Beşevler, Ankara, Turkey
| | - Hatice Pasaoglu
- Department of Biochemistry, Biyokimya AD, Gazi University Faculty of Medicine, Gazi Üniversitesi Hastanesi, 06100, Beşevler, Ankara, Turkey
| | - Nuri Cakır
- Department of Endocrinology and Metabolism, Endokrinoloji ve Metabolizma BD, Gazi University Faculty of Medicine, Gazi Üniversitesi Hastanesi, 06100, Beşevler, Ankara, Turkey
| | - Metin Arslan
- Department of Endocrinology and Metabolism, Endokrinoloji ve Metabolizma BD, Gazi University Faculty of Medicine, Gazi Üniversitesi Hastanesi, 06100, Beşevler, Ankara, Turkey
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Cavalli L, Guazzini A, Cianferotti L, Parri S, Cavalli T, Metozzi A, Giusti F, Fossi C, Black DM, Brandi ML. Prevalence of osteoporosis in the Italian population and main risk factors: results of BoneTour Campaign. BMC Musculoskelet Disord 2016; 17:396. [PMID: 27639376 PMCID: PMC5027125 DOI: 10.1186/s12891-016-1248-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 09/09/2016] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND BoneTour is a campaign conducted throughout the Italian territory for the assessment of Italian people bone status and for the prevention of osteoporosis. METHODS A total of 7305 sequential subjects of both sexes were screened, collecting clinical data through the FRAX™ questionnaire, and measuring heel bone stiffness by Quantitative Ultrasonography (QUS). The 10-year risk for hip and major osteoporotic fractures was calculated taking into account personal or family history of fragility fracture, smoking, alcohol abuse, rheumatoid arthritis, prolonged steroids assumption. Additional risk factors were evaluated, including early menopause, poor sunlight exposure, low dietary calcium intake, physical inactivity, number of pregnancies, months of lactation, tobacco cigarettes smoked per year, specific causes of secondary osteoporosis. Through a correlation study, the influence of each factor on the development of osteoporosis was analyzed. RESULTS As many as 18 % of women suffer from osteoporosis, as defined by QUS T-score. The calculation of FRAX™ confirmed the weight of the already known risk factors. The correlation study revealed the significance of some additional factors, such as hyperthyroidism, nephrolithiasis, Crohn disease, ulcerative colitis, celiac disease, poor sun exposure, and oophorectomy before age 50. CONCLUSIONS The high prevalence of secondary osteoporosis in the Italian population clearly indicates the importance of additional risk factors not yet included in the FRAX™ algorithm, for which preventive measures should be considered. Screening campaigns may allow both early diagnosis and access to treatment.
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Affiliation(s)
- Loredana Cavalli
- Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini, 6-50139, Florence, Italy
| | - Andrea Guazzini
- Department of Education and Psychology and Center for the Study of Complex Dynamics, VirtHuLab, University of Florence, Florence, Italy
| | - Luisella Cianferotti
- Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini, 6-50139, Florence, Italy
| | - Simone Parri
- Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini, 6-50139, Florence, Italy
| | - Tiziana Cavalli
- Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini, 6-50139, Florence, Italy
| | - Alessia Metozzi
- Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini, 6-50139, Florence, Italy
| | - Francesca Giusti
- Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini, 6-50139, Florence, Italy
| | - Caterina Fossi
- Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini, 6-50139, Florence, Italy
| | - Dennis M Black
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Maria Luisa Brandi
- Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini, 6-50139, Florence, Italy.
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Cruz Grecco Teixeira MB, Martins GM, Miranda-Rodrigues M, De Araújo IF, Oliveira R, Brum PC, Azevedo Gouveia CH. Lack of α2C-Adrenoceptor Results in Contrasting Phenotypes of Long Bones and Vertebra and Prevents the Thyrotoxicosis-Induced Osteopenia. PLoS One 2016; 11:e0146795. [PMID: 26815679 PMCID: PMC4729682 DOI: 10.1371/journal.pone.0146795] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 12/21/2015] [Indexed: 12/26/2022] Open
Abstract
A series of studies have demonstrated that activation of the sympathetic nervous system (SNS) causes osteopenia via β2-adrenoceptor (β2-AR) signaling. However, in a recent study, we found an unexpected and generalized phenotype of high bone mass in female mice with chronic sympathetic hyperactivity, due to double gene inactivation of adrenoceptors that negatively regulate norepinephrine release, α2A-and α2C-AR (α2A/2C-AR-/-). These findings suggest that β2-AR is not the single adrenoceptor involved in bone turnover regulation and show that α2-AR signaling may also mediate the SNS actions in the skeleton. In addition, we found that α2A/2C-AR-/- animals are resistant to the thyrotoxicosis-induced osteopenia, suggesting that thyroid hormone (TH), when in supraphysiological levels, interacts with the SNS to control bone mass and structure, and that this interaction may also involve α2-AR signaling. In the present study, to further investigate these hypotheses and to discriminate the roles of α2-AR subtypes, we have evaluated the bone phenotype of mice with the single gene inactivation of α2C-AR subtype, which mRNA expression was previously shown to be down regulated by triiodothyronine (T3). A cohort of 30 day-old female α2CAR-/- mice and their wild-type (WT) controls were treated with a supraphysiological dose of T3 for 30 or 90 days, which induced a thyrotoxic state in both mouse lineages. The micro-computed tomographic (μCT) analysis showed that α2C-AR-/- mice present lower trabecular bone volume (BV/TV) and number (Tb.N), and increased trabecular separation (Tb.Sp) in the femur compared with WT mice; which was accompanied by decreased bone strength (determined by the three-point bending test) in the femur and tibia. The opposite was observed in the vertebra, where α2C-AR-/- mice show increased BV/TV, Tb.N and trabecular thickness (Tb.Th), and decreased Tb.Sp, compared with WT animals. In spite of the contrasting bone phenotypes of the femur and L5, thyrotoxicosis negatively regulated most of the micro architectural features of the trabecular bone in both skeletal sites of WT, but not of α2C-AR-/- mice. T3 treatment also decreased biomechanical properties (maximum load and ultimate load) in the femur and tibia of WT, but not of knockout mice. The mRNA expression of osteocalcin, a marker of mature osteoblasts, and tartrate-resistant acid phosphatase, which is expressed by osteoclasts and is involved in collagen degradation, was increased by T3 treatment only in WT, and not in α2C-AR-/- mice. Altogether, these findings suggest that α2C-AR subtype mediates the effects of the SNS in the bone in a skeletal site-dependent manner, and that thyrotoxicosis depends on α2C-AR signaling to promote bone loss, which sustains the hypothesis of a TH-SNS interaction to modulate bone remodeling and structure.
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Affiliation(s)
| | - Gisele Miyamura Martins
- Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | | | | | | | - Patrícia Chakur Brum
- Departament of Biodinamic of Human Body Moviment, School of Physical Education and Sport, University of Sao Paulo, Sao Paulo, Brazil
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Bone mineral density in geriatric patients with toxic nodular goiter. Aging Clin Exp Res 2015; 27:221-6. [PMID: 25161096 DOI: 10.1007/s40520-014-0269-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 08/19/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS We aimed to assess bone mineral density (BMD) in geriatric patients with hyperthyroidism caused by TNG. MATERIALS AND METHODS Bone mineral density was measured at the lumbar spine and proximal femur, using dual-X-ray absorptiometry (DXA) in 90 patients with TNG (mean age; 69.2 ± 4.4 years) and compared with those in 42 age-matched healthy subjects (mean age; 68.40 ± 4.3 years). Serum levels of TSH, fT3, fT4, 25-OH vitamin D and PTH were measured. RESULTS BMD was significantly lower at total spine (0.904 ± 0.1 vs. 1.114 ± 0.1 g/cm(2)) and total hip (0.850 ± 0.1 vs. 1.079 ± 0.1 g/cm(2)) in male patients with TNG in comparison to the healthy men (p = 0.001, p < 0.001). Postmenopausal women with TNG had lower BMD measurements at total lumbar spine (0.754 ± 0.1 vs. 0.870 ± 0.2 g/cm(2), p < 0.001) and total hip (0.765 ± 0.1 vs. 0.831 ± 0.2 g/cm(2), p < 0.001) in comparison to the healthy women. T scores of total lumbar spine and hip were lower in patients with subclinical hyperthyroidism compared to the control group, respectively (-1.9 ± 1.7 vs -0.8 ± 1.8, p = 0.007; -1.09 ± 1.2 vs. -0.02 ± 1.6, p = 0.001). While serum levels of fT3 and fT4 revealed a negative correlation with T score of BMD measurements at the total spine and hip, TSH levels were positively correlated. We did not find a difference in serum calcium, phosphorus, 25-OH vitamin D and PTH levels between the two groups (p > 0.005). CONCLUSION Geriatric patients with hyperthyroidism secondary to TNG had reduced BMD at the total spine and hip. Thus, we suggest to investigate bone mineral density in geriatric patients with TNG.
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Tarantino U, Piccirilli E, Fantini M, Baldi J, Gasbarra E, Bei R. Sarcopenia and fragility fractures: molecular and clinical evidence of the bone-muscle interaction. J Bone Joint Surg Am 2015; 97:429-37. [PMID: 25740034 DOI: 10.2106/jbjs.n.00648] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
➤ Bone and muscle tissues are in close relationship, and the aging process is a factor involved in the loss of the functionality of both bones and muscles.➤ Sarcopenia and osteoporosis are linked from a biological and functional perspective and are related to an increased fracture risk in the elderly.➤ The increased fracture risk in sarcopenic and osteoporotic subjects is due to the decline of muscle mass and strength, the decrease in bone mineral density, and limited mobility.
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Affiliation(s)
- Umberto Tarantino
- Department of Orthopaedics and Traumatology, University Hospital Foundation, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. E-mail address for U. Tarantino:
| | - Eleonora Piccirilli
- Department of Orthopaedics and Traumatology, University Hospital Foundation, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. E-mail address for U. Tarantino:
| | - Massimo Fantini
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata," Via Montpellier 1, 00133 Rome Italy
| | - Jacopo Baldi
- Department of Orthopaedics and Traumatology, University Hospital Foundation, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. E-mail address for U. Tarantino:
| | - Elena Gasbarra
- Department of Orthopaedics and Traumatology, University Hospital Foundation, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. E-mail address for U. Tarantino:
| | - Roberto Bei
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata," Via Montpellier 1, 00133 Rome Italy
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Do Cao C, Wémeau JL. Risk-benefit ratio for TSH- suppressive Levothyroxine therapy in differentiated thyroid cancer. ANNALES D'ENDOCRINOLOGIE 2015; 76:1S47-52. [DOI: 10.1016/s0003-4266(16)30014-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Skowrońska-Jóźwiak E, Lewandowski KC, Adamczewski Z, Krawczyk-Rusiecka K, Lewiński A. Mechanisms of Normalisation of Bone Metabolism during Recovery from Hyperthyroidism: Potential Role for Sclerostin and Parathyroid Hormone. Int J Endocrinol 2015; 2015:948384. [PMID: 26366174 PMCID: PMC4561097 DOI: 10.1155/2015/948384] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 08/11/2015] [Accepted: 08/11/2015] [Indexed: 11/17/2022] Open
Abstract
Sclerostin, a protein expressed by osteocytes, is a negative regulator of bone formation. The aim of the study was to investigate the relationship between parathyroid hormone (PTH) and markers of bone metabolism and changes of sclerostin concentrations before and after treatment of hyperthyroidism. Patients and Methods. The study involved 33 patients (26 women), age (mean ± SD) 48 ± 15 years, with hyperthyroidism. Serum sclerostin, PTH, calcium, and bone markers [osteocalcin (OC) and collagen type I cross-linked C-telopeptide I (CTX)] were measured at diagnosis of hyperthyroidism and after treatment with thiamazole. Results. After treatment of hyperthyroidism a significant decrease in free T3 (FT3) and free T4 (FT4) concentrations was accompanied by marked decrease of serum sclerostin (from 43.7 ± 29.3 to 28.1 ± 18.4 pmol/L; p < 0.001), OC (from 35.6 ± 22.0 to 27.0 ± 14.3 ng/mL; p < 0.001), and CTX (from 0.49 ± 0.35 to 0.35 ± 0.23 ng/dL; p < 0.005), accompanied by an increase of PTH (from 29.3 ± 14.9 to 39.8 ± 19.8; p < 0.001). During hyperthyroidism there was a positive correlation between sclerostin and CTX (r s = 0.41, p < 0.05) and between OC and thyroid hormones (with FT3 r s = 0.42, with FT4 r s = 0.45, p < 0.05). Conclusions. Successful treatment of hyperthyroidism results in a significant decrease in serum sclerostin and bone markers concentrations, accompanied by an increase of PTH.
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Affiliation(s)
- Elżbieta Skowrońska-Jóźwiak
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, 281/289 Rzgowska Street, 90-338 Lodz, Poland
| | - Krzysztof C. Lewandowski
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, 281/289 Rzgowska Street, 90-338 Lodz, Poland
| | - Zbigniew Adamczewski
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, 281/289 Rzgowska Street, 90-338 Lodz, Poland
| | - Kinga Krawczyk-Rusiecka
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, 281/289 Rzgowska Street, 90-338 Lodz, Poland
| | - Andrzej Lewiński
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, 281/289 Rzgowska Street, 90-338 Lodz, Poland
- *Andrzej Lewiński:
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Miyamoto S, Miyamoto Y, Shibata Y, Yoshimura K, Izumida E, Suzuki H, Miyazaki T, Maki K, Kamijo R. In situ quasi-static and dynamic nanoindentation tests on calcified nodules formed by osteoblasts: Implication of glucocorticoids responsible for osteoblast calcification. Acta Biomater 2015; 12:216-226. [PMID: 25448350 DOI: 10.1016/j.actbio.2014.10.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 10/27/2014] [Accepted: 10/28/2014] [Indexed: 01/06/2023]
Abstract
The functional requirements of regenerated calcified tissues are that they enable the tissues to bear a variety of imposed stress and consequent contact-induced strain without substantial fracture. Here we demonstrate the effects of glucocorticoid hormones such as dexamethasone and hydrocortisone on the nanomechanical properties of calcified nodules formed by mouse osteoblastic MC3T3-E1 cells in differentiation-inducing medium containing ascorbic acid and β-glycerophosphate. Neither cell proliferation nor calcium deposition, evaluated using alizarin red and von Kossa staining, was affected by dexamethasone. On the other hand, calcified nodules formed in the presence of dexamethasone were significantly harder and stiffer than those formed in their absence. In particular, a series of nanoindentation tests revealed that the calcified nodules formed in the presence of dexamethasone showed enhanced stiffness against dynamic strain as compared to a quasi-static load. Furthermore, Raman spectroscopy revealed that dexamethasone and hydrocortisone increased the apatite/matrix ratio and lowered that of carbonate in the nodules. Our results suggest that glucocorticoids are required for in vitro formation by osteoblasts of more mature calcified nodules containing apatite/phosphate.
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Tuchendler D, Bolanowski M. The influence of thyroid dysfunction on bone metabolism. Thyroid Res 2014; 7:12. [PMID: 25648501 PMCID: PMC4314789 DOI: 10.1186/s13044-014-0012-0] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 12/08/2014] [Indexed: 12/04/2022] Open
Abstract
Loss of bone mineral density due to osteoporosis is the main cause of fragility fractures and leads to dropped quality of life and increased mortality. Disturbance of balance between bone formation and bone resorption is dangerous, can cause loss of bone mass and disruption of it's architecture. Correct development, achievement of peak bone mass and normal functioning of human skeleton depend on different factors. The pivotal role in bone metabolism play thyroid hormones. Both excess as well as deficiency of fT4 and fT3 can be potentially deleterious for bone tissue. The aim of this study is to review the current literature concerning the role of thyroid hormones on bone metabolism.
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Affiliation(s)
- Dominika Tuchendler
- />Endocrinology Department, Clinic of Internal Medicine, 4th Military Hospital, Wrocław, Poland
| | - Marek Bolanowski
- />Chair and Department of Endocrinology, Diabetes and Isotope Therapy, Medical University Wrocław, Wrocław, Poland
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Saler T, Ahbab S, Sağlam ZA, Keşkek ŞÖ, Kurnaz S. Endogenous subclinical hyperthyroidism may not lead to bone loss in premenopausal women. Hippokratia 2014; 18:240-244. [PMID: 25694759 PMCID: PMC4309145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Osteoporosis is defined as the decrease in bone mineral density. It is a serious health problem showing the predisposed person with increased bone fracture risk. Hyperthyroidism is one of the major causes of secondary osteoporosis. The aim of this study was to assess bone mineral density in premenopausal women with endogenous subclinical hyperthyroidism. METHODS A total of 168 subjects were included in this case-control study, of whom 86 and 82 participants were premenopausal women with subclinical hyperthyroidism and healthy premenopausal subjects, respectively. The patients with subclinical hyperthyroidism who were not receiving L-thyroxine treatment were included. The women in postmenopausal state or having chronic disease were excluded. The bone mineral densities of all subjects with dual energy X-ray absorptiometry were examined. RESULTS The Z scores (femur and L1-4) of the study group were -0.15 ± 1.15 and -0.23 ± 1.03, respectively. The Z scores of the control group were -0.39 ± 1.08 and -0.55 ± 0.98, respectively. The differences between the groups were not statistically significant (p=0.14, 0.34, respectively). CONCLUSION Our data suggest that contrary to exogenous subclinical hyperthyroidism, endogenous subclinical hyperthyroidism may not decrease bone mineral density in premenopausal women and it may not a risk factor for osteopenia or osteoporosis. Hippokratia 2014; 18 (3): 240-244.
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Affiliation(s)
- T Saler
- Internal Medicine Department of Numune Training and Research Hospital, Adana, Turkey
| | - S Ahbab
- Internal Medicine Department of Haseki Training and Research Hospital, Istanbul, Turkey
| | - Z A Sağlam
- Family Medicine Department of Medeniyet University, Goztepe Training and Research Hospital, Istanbul
| | - Ş Ö Keşkek
- Internal Medicine Department of Numune Training and Research Hospital, Adana, Turkey
| | - S Kurnaz
- Internal Medicine Department of Haseki Training and Research Hospital, Istanbul, Turkey
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