Trabecular bone deterioration in differentiated thyroid cancer: Impact of long‐term TSH suppressive therapy
Abstract Background Conflicting results has been reported regard osteoporosis and fractures in patients with Differentiated Thyroid Cancer (DTC). Our objective was to evaluate the long‐term effects of TSH suppression therapy with Levothyroxine (LT4) on trabecular bone score (TBS) and bone mineral de...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-08-01
|
| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.3200 |
| _version_ | 1797387148785090560 |
|---|---|
| author | Federico Hawkins Carranza Sonsoles Guadalix Iglesias María Luisa De Mingo Domínguez Cristina Martín‐Arriscado Arroba Begoña López Álvarez Gonzalo Allo Miguel Guillermo Martínez Díaz‐Guerra |
| author_facet | Federico Hawkins Carranza Sonsoles Guadalix Iglesias María Luisa De Mingo Domínguez Cristina Martín‐Arriscado Arroba Begoña López Álvarez Gonzalo Allo Miguel Guillermo Martínez Díaz‐Guerra |
| author_sort | Federico Hawkins Carranza |
| collection | DOAJ |
| description | Abstract Background Conflicting results has been reported regard osteoporosis and fractures in patients with Differentiated Thyroid Cancer (DTC). Our objective was to evaluate the long‐term effects of TSH suppression therapy with Levothyroxine (LT4) on trabecular bone score (TBS) and bone mineral density (BMD) in females with DTC after thyroidectomy. Methods About 145 women with resected DTC and receiving long‐term TSH therapy, were stratified according to the degree of TSH suppression. Mean duration of follow‐up was 12.3 ± 6.1 years. BMD and TBS, were assessed using dual‐energy X‐ray absorptiometry (DXA) and TBS iNsight (Med‐Imaps), at baseline (1‐3 months after surgery) and at the final study visit. Results In patients stratified by duration of TSH suppression therapy (Group I, 5‐10 years; Group II, >10 years), slight increases from baseline TSH levels were observed. Significant decreases in LS‐BMD and FN‐BMD were seen in patients after >10 years. TBS values were lower in Groups I (1.289 ± 0.122) and II (1.259 ± 0.129) compared with baseline values (P = .0001, both groups). Regarding the degree of TSH suppression, TBS was significantly reduced in those with TSH < 0.1 µU/mL (P = .0086), and not in patients with TSH suppression of 0.1.‐0.5 or >0.5 µU/mL. Conclusions We found deterioration of trabecular structure in patients with DTC and TSH suppression therapy below 0.1 µU/mL and after 5‐10 years of follow‐up. Significant changes in BMD according to TSH levels were not observed. Trabecular Bone Score is a useful technique for identifying thyroid cancer patients with risk of bone deterioration. |
| first_indexed | 2024-03-08T22:20:39Z |
| format | Article |
| id | doaj.art-d173a3dfcbea41c2854cee264114dee8 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-03-08T22:20:39Z |
| publishDate | 2020-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-d173a3dfcbea41c2854cee264114dee82023-12-18T12:56:30ZengWileyCancer Medicine2045-76342020-08-019165746575510.1002/cam4.3200Trabecular bone deterioration in differentiated thyroid cancer: Impact of long‐term TSH suppressive therapyFederico Hawkins Carranza0Sonsoles Guadalix Iglesias1María Luisa De Mingo Domínguez2Cristina Martín‐Arriscado Arroba3Begoña López Álvarez4Gonzalo Allo Miguel5Guillermo Martínez Díaz‐Guerra6Research Institute i+12 University Hospital 12 de Octubre Madrid SpainThyroid Cancer Unit Service of Endocrinology University Hospital 12 de Octubre Madrid SpainHospital La Luz Madrid SpainEpidemiology Unit Research Institute i+12University Hospital 12 de Octubre Madrid SpainCentro de Salud Goya Madrid SpainService of Endocrinology University Hospital 12 de Octubre Madrid SpainService of Endocrinology University Hospital 12 de Octubre Madrid SpainAbstract Background Conflicting results has been reported regard osteoporosis and fractures in patients with Differentiated Thyroid Cancer (DTC). Our objective was to evaluate the long‐term effects of TSH suppression therapy with Levothyroxine (LT4) on trabecular bone score (TBS) and bone mineral density (BMD) in females with DTC after thyroidectomy. Methods About 145 women with resected DTC and receiving long‐term TSH therapy, were stratified according to the degree of TSH suppression. Mean duration of follow‐up was 12.3 ± 6.1 years. BMD and TBS, were assessed using dual‐energy X‐ray absorptiometry (DXA) and TBS iNsight (Med‐Imaps), at baseline (1‐3 months after surgery) and at the final study visit. Results In patients stratified by duration of TSH suppression therapy (Group I, 5‐10 years; Group II, >10 years), slight increases from baseline TSH levels were observed. Significant decreases in LS‐BMD and FN‐BMD were seen in patients after >10 years. TBS values were lower in Groups I (1.289 ± 0.122) and II (1.259 ± 0.129) compared with baseline values (P = .0001, both groups). Regarding the degree of TSH suppression, TBS was significantly reduced in those with TSH < 0.1 µU/mL (P = .0086), and not in patients with TSH suppression of 0.1.‐0.5 or >0.5 µU/mL. Conclusions We found deterioration of trabecular structure in patients with DTC and TSH suppression therapy below 0.1 µU/mL and after 5‐10 years of follow‐up. Significant changes in BMD according to TSH levels were not observed. Trabecular Bone Score is a useful technique for identifying thyroid cancer patients with risk of bone deterioration.https://doi.org/10.1002/cam4.3200bone mineral densitydifferentiated thyroid carcinomathyrotropin suppressive therapytrabecular bone score |
| spellingShingle | Federico Hawkins Carranza Sonsoles Guadalix Iglesias María Luisa De Mingo Domínguez Cristina Martín‐Arriscado Arroba Begoña López Álvarez Gonzalo Allo Miguel Guillermo Martínez Díaz‐Guerra Trabecular bone deterioration in differentiated thyroid cancer: Impact of long‐term TSH suppressive therapy Cancer Medicine bone mineral density differentiated thyroid carcinoma thyrotropin suppressive therapy trabecular bone score |
| title | Trabecular bone deterioration in differentiated thyroid cancer: Impact of long‐term TSH suppressive therapy |
| title_full | Trabecular bone deterioration in differentiated thyroid cancer: Impact of long‐term TSH suppressive therapy |
| title_fullStr | Trabecular bone deterioration in differentiated thyroid cancer: Impact of long‐term TSH suppressive therapy |
| title_full_unstemmed | Trabecular bone deterioration in differentiated thyroid cancer: Impact of long‐term TSH suppressive therapy |
| title_short | Trabecular bone deterioration in differentiated thyroid cancer: Impact of long‐term TSH suppressive therapy |
| title_sort | trabecular bone deterioration in differentiated thyroid cancer impact of long term tsh suppressive therapy |
| topic | bone mineral density differentiated thyroid carcinoma thyrotropin suppressive therapy trabecular bone score |
| url | https://doi.org/10.1002/cam4.3200 |
| work_keys_str_mv | AT federicohawkinscarranza trabecularbonedeteriorationindifferentiatedthyroidcancerimpactoflongtermtshsuppressivetherapy AT sonsolesguadalixiglesias trabecularbonedeteriorationindifferentiatedthyroidcancerimpactoflongtermtshsuppressivetherapy AT marialuisademingodominguez trabecularbonedeteriorationindifferentiatedthyroidcancerimpactoflongtermtshsuppressivetherapy AT cristinamartinarriscadoarroba trabecularbonedeteriorationindifferentiatedthyroidcancerimpactoflongtermtshsuppressivetherapy AT begonalopezalvarez trabecularbonedeteriorationindifferentiatedthyroidcancerimpactoflongtermtshsuppressivetherapy AT gonzaloallomiguel trabecularbonedeteriorationindifferentiatedthyroidcancerimpactoflongtermtshsuppressivetherapy AT guillermomartinezdiazguerra trabecularbonedeteriorationindifferentiatedthyroidcancerimpactoflongtermtshsuppressivetherapy |