Impact of Hyperthyroidism on Biochemical Markers of Bone Metabolism

Introduction: Hyperthyroidism is a common endocrine disorder associated with multi-systemic effects, a rarely reported of which is bone loss in newly diagnosed hyperthyroid cases. Elevated thyroid hormones directly stimulate bone cells and accelerate bone turnover. Increased serum Osteocalcin (OSC)...

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Main Authors: Sarah Hashim Mhaibes, Inaam Ahmed Ameen, Eman Saadi Saleh, Kaled Nather Taha, Hawaa Salman Kamil
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2019-07-01
Series:Journal of Clinical and Diagnostic Research
Subjects:
Online Access:https://jcdr.net/articles/PDF/13011/41445_CE[Ra1]_F(KM)_PF1(AG_SHU)_PN(SL).pdf
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author Sarah Hashim Mhaibes
Inaam Ahmed Ameen
Eman Saadi Saleh
Kaled Nather Taha
Hawaa Salman Kamil
author_facet Sarah Hashim Mhaibes
Inaam Ahmed Ameen
Eman Saadi Saleh
Kaled Nather Taha
Hawaa Salman Kamil
author_sort Sarah Hashim Mhaibes
collection DOAJ
description Introduction: Hyperthyroidism is a common endocrine disorder associated with multi-systemic effects, a rarely reported of which is bone loss in newly diagnosed hyperthyroid cases. Elevated thyroid hormones directly stimulate bone cells and accelerate bone turnover. Increased serum Osteocalcin (OSC) levels can be used as a bone biomarker in hyperthyroidism disorder. Aim: To elucidate the effect of excess thyroid hormone on the serum OSC, alkaline phosphatase, calcium and phosphorus levels in newly diagnosed hyperthyroidism patients. Materials and Methods: The study was conducted at the National Center of Teaching Laboratories of Medical City Institute, Baghdad, Iraq. Newly diagnosed 50 patients with hyperthyroidism (19 males, 31 females), and 30 age and sexmatched healthy controls (9 males, 21 females) were included in the study. The detailed history of the participants were recorded and thyroid profile including Thyroid Stimulating Hormone (TSH), Total tri-iodothyronine (T3 ) and Total tetra-iodothyronine (T4 ) levels, and biochemical markers of bone metabolism-serum OSC, Alkaline Phosphatase (ALP), calcium and phosphorus were analysed. Normality was calculated using Shapiro-Wilk test. Mann-Whitney test was used to determine association among non-parametric data. Independent t-test was used to compare the difference between age groups. Receiver Operating Characteristic curve (ROC curve) was used to identify the validity of markers as an indicator of infection, and the markers were compared according to the area under the curve. Results: In hyperthyroidism patients, the serum total T4 levels, and T3 levels were significantly elevated (p-value <0.0001), while TSH (p-value <0.0001) were lowered as compared to the control group. Significant difference was observed in serum levels of OSC (p-value <0.0001), ALP (p-value <0.0001) and calcium (p-value=0.0004) levels in hyperthyroidism patients and control group, while no significant (p-value=0.17) difference was observed in serum phosphorus levels. Elevated serum OSC, ALP and calcium were significantly associated with the elevated thyroid hormones (total T3 and total T4 ). Conclusion: Association of elevated OSC, ALP and calcium levels with elevated levels of thyroid hormones in hyperthyroid patients indicates that hyperthyroidism influences the bone mineral homeostasis. OSC serves as a better biomarker than the ALP in the risk assessment of bone loss in newly diagnosed hyperthyroidism patients.
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spelling doaj.art-1a9c91edd4214acb87c0e7ba947be72c2022-12-22T01:45:47ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2019-07-01137BC11BC1410.7860/JCDR/2019/41445.13011Impact of Hyperthyroidism on Biochemical Markers of Bone MetabolismSarah Hashim Mhaibes0Inaam Ahmed Ameen1Eman Saadi Saleh2Kaled Nather Taha3Hawaa Salman Kamil4Assistant Lecturer, Department of Clinical Laboratory Sciences, College of Pharmacy, University of Baghdad, Baghdad, Iraq.Assistant Professor, Department of Clinical Laboratory Sciences, College of Pharmacy, University of Baghdad, Baghdad, Iraq.Assistant Professor Doctor, Department of Clinical Laboratory Sciences, College of Pharmacy, University of Baghdad, Baghdad, Iraq.Clinical Immunologist, Department of National Center for Education Laboratories, Ministry of Health, Baghdad, Iraq.Clinical Biochemist, Department of National Center for Education Laboratories, Ministry of Health, Baghdad, Iraq.Introduction: Hyperthyroidism is a common endocrine disorder associated with multi-systemic effects, a rarely reported of which is bone loss in newly diagnosed hyperthyroid cases. Elevated thyroid hormones directly stimulate bone cells and accelerate bone turnover. Increased serum Osteocalcin (OSC) levels can be used as a bone biomarker in hyperthyroidism disorder. Aim: To elucidate the effect of excess thyroid hormone on the serum OSC, alkaline phosphatase, calcium and phosphorus levels in newly diagnosed hyperthyroidism patients. Materials and Methods: The study was conducted at the National Center of Teaching Laboratories of Medical City Institute, Baghdad, Iraq. Newly diagnosed 50 patients with hyperthyroidism (19 males, 31 females), and 30 age and sexmatched healthy controls (9 males, 21 females) were included in the study. The detailed history of the participants were recorded and thyroid profile including Thyroid Stimulating Hormone (TSH), Total tri-iodothyronine (T3 ) and Total tetra-iodothyronine (T4 ) levels, and biochemical markers of bone metabolism-serum OSC, Alkaline Phosphatase (ALP), calcium and phosphorus were analysed. Normality was calculated using Shapiro-Wilk test. Mann-Whitney test was used to determine association among non-parametric data. Independent t-test was used to compare the difference between age groups. Receiver Operating Characteristic curve (ROC curve) was used to identify the validity of markers as an indicator of infection, and the markers were compared according to the area under the curve. Results: In hyperthyroidism patients, the serum total T4 levels, and T3 levels were significantly elevated (p-value <0.0001), while TSH (p-value <0.0001) were lowered as compared to the control group. Significant difference was observed in serum levels of OSC (p-value <0.0001), ALP (p-value <0.0001) and calcium (p-value=0.0004) levels in hyperthyroidism patients and control group, while no significant (p-value=0.17) difference was observed in serum phosphorus levels. Elevated serum OSC, ALP and calcium were significantly associated with the elevated thyroid hormones (total T3 and total T4 ). Conclusion: Association of elevated OSC, ALP and calcium levels with elevated levels of thyroid hormones in hyperthyroid patients indicates that hyperthyroidism influences the bone mineral homeostasis. OSC serves as a better biomarker than the ALP in the risk assessment of bone loss in newly diagnosed hyperthyroidism patients.https://jcdr.net/articles/PDF/13011/41445_CE[Ra1]_F(KM)_PF1(AG_SHU)_PN(SL).pdfalkaline phosphatasecalciumosteocalcinphosphorusthyroid hormone
spellingShingle Sarah Hashim Mhaibes
Inaam Ahmed Ameen
Eman Saadi Saleh
Kaled Nather Taha
Hawaa Salman Kamil
Impact of Hyperthyroidism on Biochemical Markers of Bone Metabolism
Journal of Clinical and Diagnostic Research
alkaline phosphatase
calcium
osteocalcin
phosphorus
thyroid hormone
title Impact of Hyperthyroidism on Biochemical Markers of Bone Metabolism
title_full Impact of Hyperthyroidism on Biochemical Markers of Bone Metabolism
title_fullStr Impact of Hyperthyroidism on Biochemical Markers of Bone Metabolism
title_full_unstemmed Impact of Hyperthyroidism on Biochemical Markers of Bone Metabolism
title_short Impact of Hyperthyroidism on Biochemical Markers of Bone Metabolism
title_sort impact of hyperthyroidism on biochemical markers of bone metabolism
topic alkaline phosphatase
calcium
osteocalcin
phosphorus
thyroid hormone
url https://jcdr.net/articles/PDF/13011/41445_CE[Ra1]_F(KM)_PF1(AG_SHU)_PN(SL).pdf
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