KMID : 1007020030010020113
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Korean Soceity of Osteroporosis 2003 Volume.1 No. 2 p.113 ~ p.121
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The Relationship between Subclinical Thyroid Dysfunction and Bone Mineral Metabolism in Women
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Oh Ki-Won
Yoon Eun-Joo Rhee Eun-Jung Lee Won-Young Baek Ki-Hyun Kang Moo-Il Park Cheol-Young Ihm Sung-Hee Choi Moon-Gi Yoo Hyung-Joon Park Sung-Woo
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Abstract
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Objectives: In untreated hyper or hypothyroidism decreased bone mineral density(BMD) has been demonstrated. Studies on fracture risk in patients with hyper or hypothyroidism have reported an increased risk of osteoporotic fractures. The osteoporosis associated with thyroid dysfunction is traditionally viewed as a secondary consequence of altered thyroid function. Recently, there was a report about direct effects of thyroid stimulating hormone(TSH) on both components of skeletal remodeling, osteoblastic bone formation, and osteoclastic bone resorption, mediated via the TSH receptor found on osteoblast and osteoclast precursors. Subclinical thyroid dysfunction is defined as the presence of serum thyroid hormone levels within the reference range and decreased or increased serum TSH level. Thus, the aim of this study is to investigate the relationship between subclinical thyroid dysfunction and bone mineral metabolism in women.
Methods: We observed 427 women (mean age, 52.3¡¾6.6 yr). Serum levels of TSH, free thyroxine and biochemical markers of bone turnover were measured by standard methods. BMD at lumbar spine and femoral neck were measured by dual energy X-ray absorptiometry.
Results: Femoral neck BMD was significantly reduced both in the subclinical hyperthyroid group and in the subclinical hypothyroid group as compared with euthyroid group (one-way ANOVA, p<0.001; post hoc analysis, p=0.041, p=0.033). In contrast to femoral neck BMD, lumbar spine BMD showed no difference in the two groups. Also, serum calcium and alkaline phosphatase levels, urine deoxypyridinoline levels, urine calcium to creatinine ratio showed no difference in the two groups.
Conclusion: In conclusion, women with subclinical hyperthyroidism and with subclinical hypothyroidism have reduced femoral neck BMD. However, to elucidate their mechanism, additional studies are required.
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KEYWORD
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Subclinical Thyroid Dysfunction, Thyroid stimulationg hormone, Bone Mineral density
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