scholarly journals Effects of TSH Suppressive Therapy On Bone Mineral Density (BMD) and Bone Turnover Markers (BTMs) in Patients with Differentiated Thyroid Cancer in Northeast China: A Prospective Controlled Cohort Study

2021 ◽  
Author(s):  
Shiwei Wang ◽  
Yu Wang ◽  
Li Zhu ◽  
Liang He ◽  
Mutian Lv ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Thyroid Cancer ◽  
Bone Turnover ◽  
Northeast China ◽  
Differentiated Thyroid Cancer ◽  
Suppressive Therapy ◽  
Mineral Density ◽  
Significant Difference ◽  
Turnover Markers

Abstract Purpose This study aimed to evaluate the effects of thyroid-stimulating hormone (TSH) suppressive therapy on bone mineral density (BMD) and bone turnover markers (BTMs) in differentiated thyroid cancer (DTC) patients after postoperative 1-2 years in Northeast China. Methods Five male, sixteen premenopausal, and eight postmenopausal female DTC patients receiving TSH suppressive therapy after thyroidectomy were enrolled. Patients were matched with healthy controls in a ratio of 1:2. All participants completed postoperative 1-year follow-up, and postmenopausal women completed 2-year follow-up. We measured BMD of the lumbar spine (LS), femoral neck (FN), and total hip (TH) using dual-energy X-ray absorptiometry (DXA). Bone formation marker P1NP and bone resorption marker β-CTX were also evaluated. Fracture risks were assessed by FRAX. Results There was no difference in BMD and BTMs between DTC patients and controls in the male group at 1-year follow-up. In the premenopausal women, the LS-BMD, FN-BMD, and TH-BMD in DTC patients were all higher than those in controls, but only FN-BMD showed a significant difference. The change rate of P1NP showed a significant difference between DTC patients and controls, while no difference was found in the β-CTX level. In the postmenopausal women, no difference in BMD and BTMs were observed between DTC patients and controls at the 1-year and 2-year follow-up. Conclusion Our study indicated that postoperative 1-year TSH suppressive therapy did not show detrimental effects on BMD and BTMs in men, premenopausal, and postmenopausal DTC patients. The 2-year postoperative TSH suppressive therapy did not lead to additional loss of bone mass in postmenopausal DTC patients.

Bone mineral density and bone turnover markers in patients with thyroid cancer and L-T4 suppressive therapy after 25 years of follow-up

2014 ◽  
Author(s):  
Mingo Dominguez Maria Luisa de ◽  
Sonsoles Guadalix Iglesias ◽  
Maria Begona Lopez Alvarez ◽  
Guillermo Martinez Diaz-Guerra ◽  
Federico Hawkins Carranza
Keyword(s):  
Bone Mineral Density ◽  
Thyroid Cancer ◽  
Bone Turnover ◽  
Bone Mineral ◽  
Bone Turnover Markers ◽  
Suppressive Therapy ◽  
Mineral Density ◽  
Turnover Markers

scholarly journals Observational Study to Evaluate the Effect of Epidural Steroid Injection on Bone Mineral Density and Bone Turnover Markers

2020 ◽  
Vol 5;23 (9;5) ◽  
pp. E517-E524
Author(s):  
Paras Gupta
Keyword(s):  
Bone Mineral Density ◽  
Bone Turnover ◽  
Bone Mineral ◽  
Bone Turnover Markers ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Mineral Density ◽  
Turnover Markers ◽  
Epidural Steroid

Background: Epidural steroid injection (ESI) is widely used to manage low back pain. ESIs are commonly performed to treat pain accompanying intervertebral disc prolapse, spinal stenosis, facet joint pathologies, and other degenerative spinal pathologies. Corticosteroids for musculoskeletal conditions, regardless of the route of administration, can reduce bone mineral density (BMD) and increase the risk of fracture. With paraspinal administration of steroids, the severity of risk is enhanced as the steroid is being deposited in close proximity to bone. BMD and molecular markers of bone metabolism are the standard methods to assess the effect of any insult on bone strength and bone metabolism. Carboxy terminal crosslinked telopeptides of type 1 collagen (sCTX) and serum Procollagen Type I N-terminal propeptide (P1NP) are the reference markers of bone resorption and formation, respectively. Objective: We conducted this study to determine the effect of ESI on BMD and bone turnover markers. Study Design: This was a prospective observational cohort study, involving a cohort of 264 patients between the ages of 40 to 60 years who were advised to undergo ESI at L3-4 or L4-5 by their pain physician. Setting: Research was conducted at a tertiary care teaching hospital pain clinic in collaboration with the department of orthopaedics and radiodiagnosis. Methods: Serum CTX-1, P1NP, and pre-ESI BMD of the spine, femur neck, and dual femur were evaluated at baseline; these same parameters were serially evaluated post ESI on follow-ups at 1, 3, and 6 months. Additional follow-up at 10 days post ESI was called for evaluation of bone turnover markers (BTMs). A paired t test was used to analyze changes in BMD and BTMs vs baseline within the group. Cumulative incidence and relative risk of moderate to markedly low BMD were calculated using standard formulas. Any fractures sustained during follow-ups were also evaluated thoroughly and quantified separately. A P value less than .05 was considered statistically significant. Results: The proportion of pre-ESI moderately to markedly low BMD was 10.22% in the study population. There was a statistically significant increase in serum CTX 10 days post ESI which persisted at the one-month and 3-month follow-ups. There was no significant change in serum P1NP level post ESI after 7 days and at the one-month follow-up. The mean value of serum P1NP was, however, significantly higher at the 3-month follow-up. Statistical comparison of the mean BMD value at the spine and femur neck revealed statistically significant decline 3 months post ESI. There was no significant impact of ESI on the total femur BMD. The cumulative incidence of moderately low to markedly low BMD over a period of 6 months in the study population was 45 out of 223, i.e., 20.17%. Limitations: The study’s primary limitations included its high dropout rate, a larger reference range for BTMs, making them a less specific tool for comparison, and the absence of a control group. ESI has a negative impact on the BMD of the hip and spine. Reduced BMD should be considered as a potential side effect of ESI. Key words: Bone mineral density, bone turnover markers, epidural steroid injection, low back ache, osteoporosis Pain Physician 202

scholarly journals SUN-348 Growth Hormone Replacement in Adults During 8 Years Leads to Sustained Increase in Bone Mineral Density

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Juraj Payer ◽  
Martin Kužma ◽  
Daša Stojkovičová ◽  
Juraj Smaha ◽  
Peter Jackuliak ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Growth Hormone ◽  
Bone Mass ◽  
Bone Turnover ◽  
Single Center ◽  
Mineral Density ◽  
Gh Replacement ◽  
Turnover Markers

Abstract Introduction: Adult growth hormone deficiency (AGHD) is associated with lower bone mass and likely with increased risk of fragility fractures. GH replacement leads to increase in bone mineral density (BMD).However, only few studies longer than 2 years exist. Aim: To assess long-term effect of recombinant GH replacement on BMD and bone turnover markers duringperiod of 8 years. Patients & Methods: Prospective follow-up of all (N=63) AGHD patients at one single center. All patients with adult GHD followed at single center. All participants were replaced with daily injection of recombinant human (rh) GH in IGF-1 normalizing regimen according to Endocrine Society Guidelines. Every 2 years, lumbar spine (L-spine) and total hip (TH) BMD using dual X-ray absorptiometry on Hologic Discovery device, was assessed. All patients were assessed for bone turnover markers; carboxy-terminal collagen crosslinks (CTx) and osteocalcin (OC), and 25(OH)D levels. Deficiencies of other pituitary axes were treated if necessary. All patients were supplemented with 800 IU /day of cholecalciferol and 1000-1200mg/day of calcium as recommended by International Osteoporosis Foundation. Results: Study group consisted of 38 males and 25 females (35 with adult onset (AO) /28 with childhood onset (CO); mean age at diagnosis 25,1 yrs) AGHD patients. All patients ended 8 years follow-up period without any treatment discontinuation during this period. Treatment was well tolerated, without any serious adverse event. IGF-1 has reached the normal ranges during first 6 months and remains normal during whole study period documenting good adherence to treatment (average dose of rhGH=0,4 mg/day). Both, L-spine and TH BMD increased significantly after 8 years of GH replacement (+8 % for L-spine BMD, +7,7% for TH BMD, both p<0,01). The highest peak of BMD was observed after 6 years of treatment. CTx increased by 35% (p<0,05) and remain stable, and no significant change in OC was observed during study period. Levels of 25(OH)D increased by 32% (p<0,05) from baseline. No clinical fractures were observed. Conclusion: Long-term GH replacement in adult GHD together with sufficient levels of vitamin D levels led to increase in BMD and CTx. This study supported fact that GH has sustained effect on bone mass and bone turnover and is safe and well -tolerated for the long time period.

scholarly journals Bone mineral changes during pregnancy: a cross-sectional study

2019 ◽  
Vol 8 (6) ◽  
pp. 2172
Author(s):  
Ritu Sharma ◽  
Deepali Garg ◽  
Huma Khan
Keyword(s):  
Bone Mineral Density ◽  
Bone Turnover ◽  
Pregnant Women ◽  
Bone Mineral ◽  
Serum Calcium ◽  
Bone Turnover Markers ◽  
Control Group ◽  
Mineral Density ◽  
Significant Difference ◽  
Turnover Markers

Background: Changes in bone mineral density during pregnancy are not widely studied because of the risk of radiation hazard to the fetus. But newer technology like DEXA has made it possible to measure bone density accurately with low dose radiations which are safe even during pregnancy. The aim of this study was to evaluate the changes in maternal bone turnover markers and bone mineral content at forearm during pregnancy.Methods: A total of 32 pregnant women with singleton pregnancy of more than thirty five weeks gestational age and thirty non-pregnant, non-lactating women as controls were recruited. Baseline blood investigations, serum calcium, serum alkaline phosphatase and DEXA of the forearm at ultra-distal, mid radius and proximal 1/3rd of radius were done at the time of recruitment into the study.Results: Bone mineral density of forearm of pregnancy group was compared with non-pregnant, non-lactating control group to see the effect of pregnancy. Bone turnover markers like serum calcium and serum ALP were also compared among pregnancy group and controls. The mean bone mineral density of controls at ultra-distal radius was 0.437±0.058g/cm2, while in pregnant women it was 0.431±0.58g/cm2 that was not statistically significant. Bone mineral density at mid radius in control was 0.599±0.051g/cm2 and in pregnant women it was 0.597±0.048 g/cm2 with no significant difference. BMD at proximal 1/3rd radius in controls was 0.670±0.36 g/cm2 as compared to pregnant women where it was 0.660±0.036 g/cm2 without any statistical significance. Total BMD at forearm in control and pregnant women was 0.586±0.035 and 0.582±0.036 respectively and again there was no statistically significant difference.Conclusions: There is no significant impact of pregnancy on bone mineral density of forearm. Although more bone areas need to be investigated for the further confirmation.

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