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Is previous hyperthyroidism still a risk factor for osteoporosis in post-menopausal women?
Article first published online: 28 JUN 2008
DOI: 10.1111/j.1365-2265.1995.tb02041.x
1365-2265/asset/cover.gif?v=1&s=12f46dcf32f4f74f88c9417c07f542e55ab3fb5c "Clinical Endocrinology")
Additional Information
How to Cite
Grant, D. J., McMurdo, M. E. T., Mole, P. A. and Paterson, C. R. (1995), Is previous hyperthyroidism still a risk factor for osteoporosis in post-menopausal women?. Clinical Endocrinology, 43: 339–345. doi: 10.1111/j.1365-2265.1995.tb02041.x
Publication History
- Issue published online: 28 JUN 2008
- Article first published online: 28 JUN 2008
- Received 19 January 1995; returned for revision 16 February 1995; finally revised 10 May 1995; accepted 22 May 1995
- Abstract
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- Cited By
Summary
OBJECTIVE Hyperthyroidism is a risk factor for osteoporosis, but the relative contributions of the episode of hyperthroidism and thyroxine replacement for subsequent hypothroidism remain uncertain. In this study we have measured bone mineral density (BMD) in post-menopausal women with a previous history of hyperthyroidism, comparing those requiring thyroxine therapy with those remaining euthyroid and with an historical local control population.
DESIGN Cross-sectional study.
PATIENTS One hundred and SIX post-menopausal women with a previous history of hyperthyroldism. These were divided Into four groups: treated with radiolodine, remaining euthyroid (group RU, n = 15); treated with radiolodine, receiving thyroxine for at least 5 years (group RT, n = 46); treated with surgery, remaining euthyrold (group SU, n = 21); treated with surgery, receiving thyroxine for at least 5 years (group ST, n = 24). There were 102 control subjects.
MEASUREMENT Forearm bone mineral density at distal and ultradistal sites as measured by single-photon absorptlometry.
RESULTS Results were expressed as ‘2-scores’ i.e. number of standard deviatlons from the mean of a 5-year age-band from the local control population. Mean Z-scores at distal and ultradistal sites were as follows: −0.61 and −0.81 in group RU; −0.58 and −0.56 In group RT; −0.27 and −0.30 in group SU; −0.81 and −0.57 In group ST. Patients in groups RU, RT and ST but not SU had significantly lower BMD than controls.
CONCLUSION Post-menopausal women with previous hyperthyroidism treated with radioladine have reduced BMD, whether or not receiving thyroxine. They should be targeted for densitometry and protective therapy with oestrogen should be considered. Those treated with surgery appear to be at less risk; this may be because most are diagnosed and treated whilst premenopausal. Thyroxine may have a deleterious effect in this group; longitudinal studies would provide further clarification.