Background: The associations between thyroid cancer and skeletal outcomes have not been thoroughly investigated. We aimed to investigate the risk of osteoporotic fractures in patients with thyroid cancer compared to that in a matched control group. Methods: This retrospective cohort study included 2,514 patients with thyroid cancer and 75,420 matched controls from the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC, 2006–2019). The rates of osteoporotic fractures were analyzed, and associations with the levothyroxine dose were evaluated. Results: Patients with thyroid cancer had a significantly lower risk of fracture than did the control group (hazard ratio [HR], 0.81; 95% confidence interval [CI], 0.69 to 0.94; P=0.006). Patients diagnosed with thyroid cancer after the age of 50 years (older cancer group) had a significantly lower risk of fracture than did those in the control group (HR, 0.72; 95% CI, 0.6 to 0.85; P<0.001), especially those diagnosed with spinal fractures (HR, 0.66; 95% CI, 0.51 to 0.85; P=0.001). Patients in the older cancer group started osteoporosis treatment earlier than did those in the control group (65.5±7.5 years vs. 67.3±7.6 years, P<0.001). Additionally, a lower dose of levothyroxine was associated with a reduced risk of fractures. Conclusion In the clinical setting, the risk of fracture in women diagnosed with thyroid cancer after the age of 50 years was lower than that in the control group, which was caused by more proactive osteoporosis treatment in postmenopausal women with thyroid cancer.

Background: The associations between thyroid cancer and skeletal outcomes have not been thoroughly investigated. We aimed to investigate the risk of osteoporotic fractures in patients with thyroid cancer compared to that in a matched control group. Methods: This retrospective cohort study included 2,514 patients with thyroid cancer and 75,420 matched controls from the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC, 2006–2019). The rates of osteoporotic fractures were analyzed, and associations with the levothyroxine dose were evaluated. Results: Patients with thyroid cancer had a significantly lower risk of fracture than did the control group (hazard ratio [HR], 0.81; 95% confidence interval [CI], 0.69 to 0.94; P=0.006). Patients diagnosed with thyroid cancer after the age of 50 years (older cancer group) had a significantly lower risk of fracture than did those in the control group (HR, 0.72; 95% CI, 0.6 to 0.85; P<0.001), especially those diagnosed with spinal fractures (HR, 0.66; 95% CI, 0.51 to 0.85; P=0.001). Patients in the older cancer group started osteoporosis treatment earlier than did those in the control group (65.5±7.5 years vs. 67.3±7.6 years, P<0.001). Additionally, a lower dose of levothyroxine was associated with a reduced risk of fractures. Conclusion In the clinical setting, the risk of fracture in women diagnosed with thyroid cancer after the age of 50 years was lower than that in the control group, which was caused by more proactive osteoporosis treatment in postmenopausal women with thyroid cancer.

Background: The associations between thyroid cancer and skeletal outcomes have not been thoroughly investigated. We aimed to investigate the risk of osteoporotic fractures in patients with thyroid cancer compared to that in a matched control group. Methods: This retrospective cohort study included 2,514 patients with thyroid cancer and 75,420 matched controls from the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC, 2006–2019). The rates of osteoporotic fractures were analyzed, and associations with the levothyroxine dose were evaluated. Results: Patients with thyroid cancer had a significantly lower risk of fracture than did the control group (hazard ratio [HR], 0.81; 95% confidence interval [CI], 0.69 to 0.94; P=0.006). Patients diagnosed with thyroid cancer after the age of 50 years (older cancer group) had a significantly lower risk of fracture than did those in the control group (HR, 0.72; 95% CI, 0.6 to 0.85; P<0.001), especially those diagnosed with spinal fractures (HR, 0.66; 95% CI, 0.51 to 0.85; P=0.001). Patients in the older cancer group started osteoporosis treatment earlier than did those in the control group (65.5±7.5 years vs. 67.3±7.6 years, P<0.001). Additionally, a lower dose of levothyroxine was associated with a reduced risk of fractures. Conclusion In the clinical setting, the risk of fracture in women diagnosed with thyroid cancer after the age of 50 years was lower than that in the control group, which was caused by more proactive osteoporosis treatment in postmenopausal women with thyroid cancer.

Background: The associations between thyroid cancer and skeletal outcomes have not been thoroughly investigated. We aimed to investigate the risk of osteoporotic fractures in patients with thyroid cancer compared to that in a matched control group. Methods: This retrospective cohort study included 2,514 patients with thyroid cancer and 75,420 matched controls from the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC, 2006–2019). The rates of osteoporotic fractures were analyzed, and associations with the levothyroxine dose were evaluated. Results: Patients with thyroid cancer had a significantly lower risk of fracture than did the control group (hazard ratio [HR], 0.81; 95% confidence interval [CI], 0.69 to 0.94; P=0.006). Patients diagnosed with thyroid cancer after the age of 50 years (older cancer group) had a significantly lower risk of fracture than did those in the control group (HR, 0.72; 95% CI, 0.6 to 0.85; P<0.001), especially those diagnosed with spinal fractures (HR, 0.66; 95% CI, 0.51 to 0.85; P=0.001). Patients in the older cancer group started osteoporosis treatment earlier than did those in the control group (65.5±7.5 years vs. 67.3±7.6 years, P<0.001). Additionally, a lower dose of levothyroxine was associated with a reduced risk of fractures. Conclusion In the clinical setting, the risk of fracture in women diagnosed with thyroid cancer after the age of 50 years was lower than that in the control group, which was caused by more proactive osteoporosis treatment in postmenopausal women with thyroid cancer.

Non-sugar sweeteners (NSS) are low in calories and can be used in very small amounts. Both the U.S. Food and Drug Administration and Korea Ministry of Food and Drug Safety have stated that consuming NSS within the recommended dosage is not harmful to human health. Nonetheless, the World Health Organization in its 2023 guidelines on NSS use advised the general population against the consumption of NSS as a means of controlling weight and reducing the risk of chronic diseases, including diabetes. However, there is insufficient evidence regarding the health benefits and potential risks of NSS for patients with diabetes. Given the ongoing debate about the efficacy of NSS, the 2023 clinical guidelines of the Korean Diabetes Association recommend minimizing beverages containing sugar or NSS, although NSS may help reduce sugar intake in the short term. This review aims to explore the latest research on the benefits and risks of NSS for the general population and patients with diabetes.

Non-sugar sweeteners (NSS) are low in calories and can be used in very small amounts. Both the U.S. Food and Drug Administration and Korea Ministry of Food and Drug Safety have stated that consuming NSS within the recommended dosage is not harmful to human health. Nonetheless, the World Health Organization in its 2023 guidelines on NSS use advised the general population against the consumption of NSS as a means of controlling weight and reducing the risk of chronic diseases, including diabetes. However, there is insufficient evidence regarding the health benefits and potential risks of NSS for patients with diabetes. Given the ongoing debate about the efficacy of NSS, the 2023 clinical guidelines of the Korean Diabetes Association recommend minimizing beverages containing sugar or NSS, although NSS may help reduce sugar intake in the short term. This review aims to explore the latest research on the benefits and risks of NSS for the general population and patients with diabetes.

Non-sugar sweeteners (NSS) are low in calories and can be used in very small amounts. Both the U.S. Food and Drug Administration and Korea Ministry of Food and Drug Safety have stated that consuming NSS within the recommended dosage is not harmful to human health. Nonetheless, the World Health Organization in its 2023 guidelines on NSS use advised the general population against the consumption of NSS as a means of controlling weight and reducing the risk of chronic diseases, including diabetes. However, there is insufficient evidence regarding the health benefits and potential risks of NSS for patients with diabetes. Given the ongoing debate about the efficacy of NSS, the 2023 clinical guidelines of the Korean Diabetes Association recommend minimizing beverages containing sugar or NSS, although NSS may help reduce sugar intake in the short term. This review aims to explore the latest research on the benefits and risks of NSS for the general population and patients with diabetes.

Non-sugar sweeteners (NSS) are low in calories and can be used in very small amounts. Both the U.S. Food and Drug Administration and Korea Ministry of Food and Drug Safety have stated that consuming NSS within the recommended dosage is not harmful to human health. Nonetheless, the World Health Organization in its 2023 guidelines on NSS use advised the general population against the consumption of NSS as a means of controlling weight and reducing the risk of chronic diseases, including diabetes. However, there is insufficient evidence regarding the health benefits and potential risks of NSS for patients with diabetes. Given the ongoing debate about the efficacy of NSS, the 2023 clinical guidelines of the Korean Diabetes Association recommend minimizing beverages containing sugar or NSS, although NSS may help reduce sugar intake in the short term. This review aims to explore the latest research on the benefits and risks of NSS for the general population and patients with diabetes.

Non-sugar sweeteners (NSS) are low in calories and can be used in very small amounts. Both the U.S. Food and Drug Administration and Korea Ministry of Food and Drug Safety have stated that consuming NSS within the recommended dosage is not harmful to human health. Nonetheless, the World Health Organization in its 2023 guidelines on NSS use advised the general population against the consumption of NSS as a means of controlling weight and reducing the risk of chronic diseases, including diabetes. However, there is insufficient evidence regarding the health benefits and potential risks of NSS for patients with diabetes. Given the ongoing debate about the efficacy of NSS, the 2023 clinical guidelines of the Korean Diabetes Association recommend minimizing beverages containing sugar or NSS, although NSS may help reduce sugar intake in the short term. This review aims to explore the latest research on the benefits and risks of NSS for the general population and patients with diabetes.

Background: Many studies have shown that Hashimoto’s thyroiditis (HT) acts as a protective factor in differentiated thyroid cancer (DTC), but little is known about its effects on mortality. Therefore, this study was performed to reveal the prognosis of HT on mortality in patients with DTC. Methods: This study included two types of research results: retrospective cohort study using the National Epidemiologic Survey of Thyroid cancer (NEST) in Korea and meta-analysis study with the NEST data and eight selected studies. Results: Of the 4,398 patients with DTC in NEST, 341 patients (7.8%) died during the median follow-up period of 15 years (interquartile range, 12.3 to 15.6). Of these, 91 deaths (2.1%) were related to DTC. HT was associated with a smaller tumor size and less aggressive DTC. In Cox regression analysis after adjusting for age and sex, patients with HT showed a significantly lower risk of all-cause death (hazard ratio [HR], 0.71; 95% confidence interval [CI], 0.52 to 0.96) and DTC-related death (HR, 0.33; 95% CI, 0.14 to 0.77). The analysis with inverse probability of treatment weight data adjusted for age, sex, and year of thyroid cancer registration showed similar association. The meta-analysis showed that patients with HT showed a lower risk of all-cause mortality (risk ratio [RR], 0.24; 95% CI, 0.13 to 0.47) and thyroid cancer-related mortality (RR, 0.23; 95% CI, 0.13 to 0.40) in comparison with patients without HT. Conclusion This study showed that DTC co-presenting with HT is associated with a low risk of advanced DTC and presents a low risk for all-cause and DTC-related death.