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Influence of Thyroid-stimulating Hormone Suppression Therapy on Bone Mineral Density in Patients with Differentiated Thyroid Cancer: A Meta-analysis

이유진|김성한|오현진|이영균|윤병호
대한골대사학회 (The Korean Society of Bone Metabolism)|2019.02|대한골대사학회지 (Journal of Bone Metabolism)|제26권 제1호|pp. 51-60

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키워드

Meta-analysisOsteoporosisBone densityThyroid neoplasms
주제분류정형외과학

초록

Background: The effects of subclinical hyperthyroidism on bone mineral density (BMD) induced by thyroid-stimulating hormone (TSH) suppression therapy in patients with differentiated thyroid cancer (DTC) remains unclear. We conducted a meta-analysis to determine the influence of TSH suppression therapy on BMD. Methods: We performed a systematic search to identify studies which included BMD measurement of femoral neck, total hip or lumbar spine in patients on TSH suppression therapy for DTC. Main outcome measures were difference of BMD of femoral neck, total hip or lumbar spine measured by dual energy X-ray absorptiometry between patients and controls. Results: A systematic search yielded a total of 11 published controlled cross-sectional studies (including about 571 patients and 836 controls). TSH suppression therapy was associated with the lower BMD of total hip (weighted mean difference [WMD], -0.023; 95% confidence interval [CI], -0.047 to 0.000; P=0.050) and spine (WMD, -0.041; 95% CI, -0.057 to -0.026; P<0.001) in postmenopausal women with DTC, while it was not associated with that in premenopausal women and men with DTC. Conclusions: Although the included studies were limited by small numbers, results suggested possible association between chronic TSH suppression therapy and the lower BMD of spine and total hip in postmenopausal women (but not in premenopausal women and men) with DTC. A large, well-designed study with long-term follow-up would provide further insight into the influence of TSH suppression therapy and loss of BMD.

Abstract

Background: The effects of subclinical hyperthyroidism on bone mineral density (BMD) induced by thyroid-stimulating hormone (TSH) suppression therapy in patients with differentiated thyroid cancer (DTC) remains unclear. We conducted a meta-analysis to determine the influence of TSH suppression therapy on BMD. Methods: We performed a systematic search to identify studies which included BMD measurement of femoral neck, total hip or lumbar spine in patients on TSH suppression therapy for DTC. Main outcome measures were difference of BMD of femoral neck, total hip or lumbar spine measured by dual energy X-ray absorptiometry between patients and controls. Results: A systematic search yielded a total of 11 published controlled cross-sectional studies (including about 571 patients and 836 controls). TSH suppression therapy was associated with the lower BMD of total hip (weighted mean difference [WMD], -0.023; 95% confidence interval [CI], -0.047 to 0.000; P=0.050) and spine (WMD, -0.041; 95% CI, -0.057 to -0.026; P<0.001) in postmenopausal women with DTC, while it was not associated with that in premenopausal women and men with DTC. Conclusions: Although the included studies were limited by small numbers, results suggested possible association between chronic TSH suppression therapy and the lower BMD of spine and total hip in postmenopausal women (but not in premenopausal women and men) with DTC. A large, well-designed study with long-term follow-up would provide further insight into the influence of TSH suppression therapy and loss of BMD.

참고문헌 (57)

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관련 논문AI추천

Risk of Osteoporotic Fractures after Thyroid-stimulating Hormone Suppression Therapy in Patients with Thyroid Cancer윤병호, 이시연, 이영균, 이유진, 정연경대한골대사학회 · 대한골대사학회지2019 · 제26권 제1호Effect of Thyroid-Stimulating Hormone Suppression on Bone Mineral Density in Patients with Differentiated Thyroid Carcinoma: A Single Center Retrospective Study유원상대한골대사학회 · 대한골대사학회지2025 · 제32권 제3호Effects of Thyrotropin Suppression on Bone Health in Menopausal Women with Total Thyroidectomy고태식, 김근영, 김보현, 김상수, 김성장, 김은희, 김인주, 박경준, 신승현, 이병주, 이정규, 전윤경대한골대사학회 · 대한골대사학회지2019 · 제26권 제1호Change of Bone Mineral Density and Biochemical Markers of Bone Turnover in Patients on Suppressive Levothyroxine Therapy for Differentiated Thyroid Carcinoma김소헌, 김용성, 김채원, 남문석, 오세환, 이정진, 한주영, 홍석보, 홍성빈대한골대사학회 · 대한골대사학회지2015 · 제22권 제3호Bone Mineral Density in Thyroid Cancer Patients: Data from the Korea National Health and Nutrition Examination Survey장명철대한내분비외과학회 · Journal of Endocrine Surgery2017 · 제17권 제4호분화갑상선암 수술 후 갑상선자극호르몬 억제요법과 골다공증박경식대한내분비외과학회 · Journal of Endocrine Surgery2016 · 제16권 제1호

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