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Association between subclinical thyroid dysfunction and change in bone mineral density in prospective cohorts.
Tuesday,2018-01-16 18:30 America/Los_Angeles — ecterry
| Title | Association between subclinical thyroid dysfunction and change in bone mineral density in prospective cohorts. |
| Publication Type | Journal Article |
| Year of Publication | 2018 |
| Authors | Segna, D, Bauer, DC, Feller, M, Schneider, C, Fink, HA, Aubert, CE, Collet, T-H, da Costa, BR, Fischer, K, Peeters, RP, Cappola, AR, Blum, MR, van Dorland, HA, Robbins, J, Naylor, K, Eastell, R, Uitterlinden, AG, F Ramirez, R, Gogakos, A, Gussekloo, J, Williams, GR, Schwartz, A, Cauley, JA, Aujesky, DA, Bischoff-Ferrari, HA, Rodondi, N |
| Corporate/Institutional Authors | Thyroid Studies Collaboration, |
| Journal | J Intern Med |
| Volume | 283 |
| Issue | 1 |
| Pagination | 56-72 |
| Date Published | 2018 Jan |
| ISSN | 1365-2796 |
| Keywords | Aged, Asymptomatic Diseases, Bone Density, Female, Fractures, Bone, Humans, Hyperthyroidism, Hypothyroidism, Male, Risk Factors |
| Abstract | <p><b>BACKGROUND: </b>Subclinical hyperthyroidism (SHyper) has been associated with increased risk of hip and other fractures, but the linking mechanisms remain unclear.</p><p><b>OBJECTIVE: </b>To investigate the association between subclinical thyroid dysfunction and bone loss.</p><p><b>METHODS: </b>Individual participant data analysis was performed after a systematic literature search in MEDLINE/EMBASE (1946-2016). Two reviewers independently screened and selected prospective cohorts providing baseline thyroid status and serial bone mineral density (BMD) measurements. We classified thyroid status as euthyroidism (thyroid-stimulating hormone [TSH] 0.45-4.49 mIU/L), SHyper (TSH < 0.45 mIU/L) and subclinical hypothyroidism (SHypo, TSH ≥ 4.50-19.99 mIU/L) both with normal free thyroxine levels. Our primary outcome was annualized percentage BMD change (%ΔBMD) from serial dual X-ray absorptiometry scans of the femoral neck, total hip and lumbar spine, obtained from multivariable regression in a random-effects two-step approach.</p><p><b>RESULTS: </b>Amongst 5458 individuals (median age 72 years, 49.1% women) from six prospective cohorts, 451 (8.3%) had SHypo and 284 (5.2%) had SHyper. During 36 569 person-years of follow-up, those with SHyper had a greater annual bone loss at the femoral neck versus euthyroidism: %ΔBMD = -0.18 (95% CI: -0.34, -0.02; I2 = 0%), with a nonstatistically significant pattern at the total hip: %ΔBMD = -0.14 (95% CI: -0.38, 0.10; I2 = 53%), but not at the lumbar spine: %ΔBMD = 0.03 (95% CI: -0.30, 0.36; I2 = 25%); especially participants with TSH < 0.10 mIU/L showed an increased bone loss in the femoral neck (%Δ BMD = -0.59; [95% CI: -0.99, -0.19]) and total hip region (%ΔBMD = -0.46 [95% CI: -1.05, -0.13]). In contrast, SHypo was not associated with bone loss at any site.</p><p><b>CONCLUSION: </b>Amongst adults, SHyper was associated with increased femoral neck bone loss, potentially contributing to the increased fracture risk.</p> |
| DOI | 10.1111/joim.12688 |
| Alternate Journal | J. Intern. Med. |
| PubMed ID | 29034571 |
| PubMed Central ID | PMC5739958 |
| Grant List | N01 HC085081 / HC / NHLBI NIH HHS / United States N01 AG062101 / AG / NIA NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States UL1 TR000128 / TR / NCATS NIH HHS / United States HHSN268200800007C / HL / NHLBI NIH HHS / United States N01 HC085083 / HC / NHLBI NIH HHS / United States U01 AG042124 / AG / NIA NIH HHS / United States N01 AG062106 / AG / NIA NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States U01 AG042145 / AG / NIA NIH HHS / United States R01 NR012459 / NR / NINR NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States N01 HC085080 / HC / NHLBI NIH HHS / United States HHSN268201200036C / HL / NHLBI NIH HHS / United States N01 AG062103 / AG / NIA NIH HHS / United States U01 AG042168 / AG / NIA NIH HHS / United States U01 AG042140 / AG / NIA NIH HHS / United States R01 AG028050 / AG / NIA NIH HHS / United States N01HC85082 / HL / NHLBI NIH HHS / United States N01HC85083 / HL / NHLBI NIH HHS / United States U01 AG027810 / AG / NIA NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01 HC085079 / HC / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States N01HC85080 / HL / NHLBI NIH HHS / United States U01 AG042143 / AG / NIA NIH HHS / United States U01 AG042139 / AG / NIA NIH HHS / United States U01 AR066160 / AR / NIAMS NIH HHS / United States N01HC85081 / HL / NHLBI NIH HHS / United States |
ePub date:
18/01