Influence of Thyroid-stimulating Hormone Suppression Therapy on Bone Mineral Density in Patients with Differentiated Thyroid Cancer: A Meta-analysis
10.11005/jbm.2019.26.1.51
- Author:
Byung Ho YOON
1
;
Youjin LEE
;
Hyun Jin OH
;
Sung Han KIM
;
Young Kyun LEE
Author Information
1. Department of Orthopaedic Surgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, Korea.
- Publication Type:Meta-Analysis
- Keywords:
Bone density;
Meta-analysis;
Osteoporosis;
Thyroid neoplasms
- MeSH:
Absorptiometry, Photon;
Bone Density;
Cross-Sectional Studies;
Female;
Femur Neck;
Follow-Up Studies;
Hip;
Humans;
Hyperthyroidism;
Male;
Osteoporosis;
Outcome Assessment (Health Care);
Spine;
Thyroid Gland;
Thyroid Neoplasms;
Thyrotropin
- From:Journal of Bone Metabolism
2019;26(1):51-60
- CountryRepublic of Korea
- Language:English
-
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.
