Bone mineral density and bone turnover markers in patients on long-term suppressive levothyroxine therapy for differentiated thyroid cancer

Mi Young Lee, Jae Hyun Park, Keum Seok Bae, Yong Gwan Jee, An Na Ko, Yong Jea Han, Jang Yel Shin, Jung Soo Lim, Choon Hee Chung, Seong Joon Kang

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Purpose: Current management for patients with differentiated thyroid cancer includes near total thyroidectomy and radioactive iodine therapy followed by administration of supraphysiological doses of levothyroxine (L-T4). Although hyperthyroidism is a well known risk factor for osteoporosis, the effects of L-T4 treatment on bone mineral density (BMD) in patients with thyroid cancer do not appear to be as significant as with endogenous hyperthyroidism. In this study, we evaluated the impact of long-term suppressive therapy with L-T4 on BMD and bone turn over markers in Korean female patients receiving L-T4 suppressive therapy. Methods: We enrolled 94 female subjects (mean age, 50.84 ± 11.43 years) receiving L-T4 after total or near total thyroidectomy and radioactive iodine therapy for thyroid cancer (mean follow-up period, 12.17 ± 4.27 years). The subjects were divided into three groups by thyroid stimulating hormone (TSH) level (group 1 with TSH level =0.001 μIU/mL, group 2 with TSH level between 0.001 and 0.17 μIU/mL, group 3 with TSH level >0.17 μIU/mL) and four groups by quartile of free T4 level. L-T4 dosage, BMD (examined by dual-energy x-ray absorptiometry), and bone turnover markers were evaluated according to TSH and free T4 levels. Results: No significant decrease was detected in BMD or bone turnover markers according to TSH level or free T4 level. Also, the prevalence of osteoporosis and osteopenia was not different among groups. Conclusion: Long-term L-T4 suppressive therapy after thyroid cancer management did not affect bone density or increase the prevalence of osteoporosis even though TSH levels were supraphysiologically suppressed.

Original languageEnglish
Pages (from-to)55-60
Number of pages6
JournalAnnals of Surgical Treatment and Research
Volume86
Issue number2
DOIs
Publication statusPublished - 2014 Feb

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Bone Remodeling
Thyrotropin
Thyroxine
Thyroid Neoplasms
Bone Density
Bone and Bones
Osteoporosis
Thyroidectomy
Hyperthyroidism
Iodine
Therapeutics
Metabolic Bone Diseases
X-Rays

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Lee, Mi Young ; Park, Jae Hyun ; Bae, Keum Seok ; Jee, Yong Gwan ; Ko, An Na ; Han, Yong Jea ; Shin, Jang Yel ; Lim, Jung Soo ; Chung, Choon Hee ; Kang, Seong Joon. / Bone mineral density and bone turnover markers in patients on long-term suppressive levothyroxine therapy for differentiated thyroid cancer. In: Annals of Surgical Treatment and Research. 2014 ; Vol. 86, No. 2. pp. 55-60.
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abstract = "Purpose: Current management for patients with differentiated thyroid cancer includes near total thyroidectomy and radioactive iodine therapy followed by administration of supraphysiological doses of levothyroxine (L-T4). Although hyperthyroidism is a well known risk factor for osteoporosis, the effects of L-T4 treatment on bone mineral density (BMD) in patients with thyroid cancer do not appear to be as significant as with endogenous hyperthyroidism. In this study, we evaluated the impact of long-term suppressive therapy with L-T4 on BMD and bone turn over markers in Korean female patients receiving L-T4 suppressive therapy. Methods: We enrolled 94 female subjects (mean age, 50.84 ± 11.43 years) receiving L-T4 after total or near total thyroidectomy and radioactive iodine therapy for thyroid cancer (mean follow-up period, 12.17 ± 4.27 years). The subjects were divided into three groups by thyroid stimulating hormone (TSH) level (group 1 with TSH level =0.001 μIU/mL, group 2 with TSH level between 0.001 and 0.17 μIU/mL, group 3 with TSH level >0.17 μIU/mL) and four groups by quartile of free T4 level. L-T4 dosage, BMD (examined by dual-energy x-ray absorptiometry), and bone turnover markers were evaluated according to TSH and free T4 levels. Results: No significant decrease was detected in BMD or bone turnover markers according to TSH level or free T4 level. Also, the prevalence of osteoporosis and osteopenia was not different among groups. Conclusion: Long-term L-T4 suppressive therapy after thyroid cancer management did not affect bone density or increase the prevalence of osteoporosis even though TSH levels were supraphysiologically suppressed.",
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Bone mineral density and bone turnover markers in patients on long-term suppressive levothyroxine therapy for differentiated thyroid cancer. / Lee, Mi Young; Park, Jae Hyun; Bae, Keum Seok; Jee, Yong Gwan; Ko, An Na; Han, Yong Jea; Shin, Jang Yel; Lim, Jung Soo; Chung, Choon Hee; Kang, Seong Joon.

In: Annals of Surgical Treatment and Research, Vol. 86, No. 2, 02.2014, p. 55-60.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Bone mineral density and bone turnover markers in patients on long-term suppressive levothyroxine therapy for differentiated thyroid cancer

AU - Lee, Mi Young

AU - Park, Jae Hyun

AU - Bae, Keum Seok

AU - Jee, Yong Gwan

AU - Ko, An Na

AU - Han, Yong Jea

AU - Shin, Jang Yel

AU - Lim, Jung Soo

AU - Chung, Choon Hee

AU - Kang, Seong Joon

PY - 2014/2

Y1 - 2014/2

N2 - Purpose: Current management for patients with differentiated thyroid cancer includes near total thyroidectomy and radioactive iodine therapy followed by administration of supraphysiological doses of levothyroxine (L-T4). Although hyperthyroidism is a well known risk factor for osteoporosis, the effects of L-T4 treatment on bone mineral density (BMD) in patients with thyroid cancer do not appear to be as significant as with endogenous hyperthyroidism. In this study, we evaluated the impact of long-term suppressive therapy with L-T4 on BMD and bone turn over markers in Korean female patients receiving L-T4 suppressive therapy. Methods: We enrolled 94 female subjects (mean age, 50.84 ± 11.43 years) receiving L-T4 after total or near total thyroidectomy and radioactive iodine therapy for thyroid cancer (mean follow-up period, 12.17 ± 4.27 years). The subjects were divided into three groups by thyroid stimulating hormone (TSH) level (group 1 with TSH level =0.001 μIU/mL, group 2 with TSH level between 0.001 and 0.17 μIU/mL, group 3 with TSH level >0.17 μIU/mL) and four groups by quartile of free T4 level. L-T4 dosage, BMD (examined by dual-energy x-ray absorptiometry), and bone turnover markers were evaluated according to TSH and free T4 levels. Results: No significant decrease was detected in BMD or bone turnover markers according to TSH level or free T4 level. Also, the prevalence of osteoporosis and osteopenia was not different among groups. Conclusion: Long-term L-T4 suppressive therapy after thyroid cancer management did not affect bone density or increase the prevalence of osteoporosis even though TSH levels were supraphysiologically suppressed.

AB - Purpose: Current management for patients with differentiated thyroid cancer includes near total thyroidectomy and radioactive iodine therapy followed by administration of supraphysiological doses of levothyroxine (L-T4). Although hyperthyroidism is a well known risk factor for osteoporosis, the effects of L-T4 treatment on bone mineral density (BMD) in patients with thyroid cancer do not appear to be as significant as with endogenous hyperthyroidism. In this study, we evaluated the impact of long-term suppressive therapy with L-T4 on BMD and bone turn over markers in Korean female patients receiving L-T4 suppressive therapy. Methods: We enrolled 94 female subjects (mean age, 50.84 ± 11.43 years) receiving L-T4 after total or near total thyroidectomy and radioactive iodine therapy for thyroid cancer (mean follow-up period, 12.17 ± 4.27 years). The subjects were divided into three groups by thyroid stimulating hormone (TSH) level (group 1 with TSH level =0.001 μIU/mL, group 2 with TSH level between 0.001 and 0.17 μIU/mL, group 3 with TSH level >0.17 μIU/mL) and four groups by quartile of free T4 level. L-T4 dosage, BMD (examined by dual-energy x-ray absorptiometry), and bone turnover markers were evaluated according to TSH and free T4 levels. Results: No significant decrease was detected in BMD or bone turnover markers according to TSH level or free T4 level. Also, the prevalence of osteoporosis and osteopenia was not different among groups. Conclusion: Long-term L-T4 suppressive therapy after thyroid cancer management did not affect bone density or increase the prevalence of osteoporosis even though TSH levels were supraphysiologically suppressed.

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