Utility of C-terminal Telopeptide in Evaluating Levothyroxine Replacement Therapy-Induced Bone Loss
Background Levothyroxine (LT4) therapy has shown to have effects on bone metabolism though its deleterious effect on bone remodeling is debatable. This study was aimed at assessing the diagnostic utility of the bone remodeling marker C-terminal telopeptide (CTx) in detecting early bone loss. Materia...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2014-01-01
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| Series: | Biomarker Insights |
| Online Access: | https://doi.org/10.4137/BMI.S13965 |
| _version_ | 1819010569649258496 |
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| author | Alap L. Christy Vivian D'Souza Ruby P. Babu Sohil Takodara Poornima Manjrekar Anupama Hegde M. S. Rukmini |
| author_facet | Alap L. Christy Vivian D'Souza Ruby P. Babu Sohil Takodara Poornima Manjrekar Anupama Hegde M. S. Rukmini |
| author_sort | Alap L. Christy |
| collection | DOAJ |
| description | Background Levothyroxine (LT4) therapy has shown to have effects on bone metabolism though its deleterious effect on bone remodeling is debatable. This study was aimed at assessing the diagnostic utility of the bone remodeling marker C-terminal telopeptide (CTx) in detecting early bone loss. Materials and Methods In this case–control study, 84 premenopausal women of 30–45 years of age were selected. Out of them, 28 were recently diagnosed of hypothyroidism (not on LT4), 28 were on LT4 replacement therapy (100–200 μg/day) for more than five years, and 28 had euthyroid. Plasma CTx levels were estimated. Bone mineral density (BMD) was measured by quantitative ultrasound (QUS) method. Pearson's coefficient of correlation and ANOVA were used for statistical analysis. Results CTx was most elevated in LT4-treated group (0.497 ± 0.209 ng/mL). It showed a significant negative correlation with T -score and Z -score of BMD values. In the treatment group of more than 150 μg/day, CTx showed significantly negative correlation with TSH ( r = – 0.462, P = 0.047). Conclusion LT4 therapy induces bone loss in hypothyroid patients. CTx levels can measure such bone loss along with BMD. Regular monitoring of CTx with adjustment in LT4 doses may help delay osteoporosis induced by prolonged LT4 replacement therapy. |
| first_indexed | 2024-12-21T01:14:21Z |
| format | Article |
| id | doaj.art-66369562d2bd43c6888e41b3f2eef55a |
| institution | Directory Open Access Journal |
| issn | 1177-2719 |
| language | English |
| last_indexed | 2024-12-21T01:14:21Z |
| publishDate | 2014-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Biomarker Insights |
| spelling | doaj.art-66369562d2bd43c6888e41b3f2eef55a2022-12-21T19:20:49ZengSAGE PublishingBiomarker Insights1177-27192014-01-01910.4137/BMI.S13965Utility of C-terminal Telopeptide in Evaluating Levothyroxine Replacement Therapy-Induced Bone LossAlap L. Christy0Vivian D'Souza1Ruby P. Babu2Sohil Takodara3Poornima Manjrekar4Anupama Hegde5M. S. Rukmini6Department of Biochemistry, Kasturba Medical College, Manipal University, Mangalore, India.Department of Biochemistry, Kasturba Medical College, Manipal University, Mangalore, India.Department of Biochemistry, Kasturba Medical College, Manipal University, Mangalore, India.Department of Biochemistry, Kasturba Medical College, Manipal University, Mangalore, India.Department of Biochemistry, Kasturba Medical College, Manipal University, Mangalore, India.Department of Biochemistry, Kasturba Medical College, Manipal University, Mangalore, India.Department of Biochemistry, Kasturba Medical College, Manipal University, Mangalore, India.Background Levothyroxine (LT4) therapy has shown to have effects on bone metabolism though its deleterious effect on bone remodeling is debatable. This study was aimed at assessing the diagnostic utility of the bone remodeling marker C-terminal telopeptide (CTx) in detecting early bone loss. Materials and Methods In this case–control study, 84 premenopausal women of 30–45 years of age were selected. Out of them, 28 were recently diagnosed of hypothyroidism (not on LT4), 28 were on LT4 replacement therapy (100–200 μg/day) for more than five years, and 28 had euthyroid. Plasma CTx levels were estimated. Bone mineral density (BMD) was measured by quantitative ultrasound (QUS) method. Pearson's coefficient of correlation and ANOVA were used for statistical analysis. Results CTx was most elevated in LT4-treated group (0.497 ± 0.209 ng/mL). It showed a significant negative correlation with T -score and Z -score of BMD values. In the treatment group of more than 150 μg/day, CTx showed significantly negative correlation with TSH ( r = – 0.462, P = 0.047). Conclusion LT4 therapy induces bone loss in hypothyroid patients. CTx levels can measure such bone loss along with BMD. Regular monitoring of CTx with adjustment in LT4 doses may help delay osteoporosis induced by prolonged LT4 replacement therapy.https://doi.org/10.4137/BMI.S13965 |
| spellingShingle | Alap L. Christy Vivian D'Souza Ruby P. Babu Sohil Takodara Poornima Manjrekar Anupama Hegde M. S. Rukmini Utility of C-terminal Telopeptide in Evaluating Levothyroxine Replacement Therapy-Induced Bone Loss Biomarker Insights |
| title | Utility of C-terminal Telopeptide in Evaluating Levothyroxine Replacement Therapy-Induced Bone Loss |
| title_full | Utility of C-terminal Telopeptide in Evaluating Levothyroxine Replacement Therapy-Induced Bone Loss |
| title_fullStr | Utility of C-terminal Telopeptide in Evaluating Levothyroxine Replacement Therapy-Induced Bone Loss |
| title_full_unstemmed | Utility of C-terminal Telopeptide in Evaluating Levothyroxine Replacement Therapy-Induced Bone Loss |
| title_short | Utility of C-terminal Telopeptide in Evaluating Levothyroxine Replacement Therapy-Induced Bone Loss |
| title_sort | utility of c terminal telopeptide in evaluating levothyroxine replacement therapy induced bone loss |
| url | https://doi.org/10.4137/BMI.S13965 |
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