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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

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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 baseline P1NP was significantly lower in DTC patients than in the controls. The LS-BMD, FN-BMD, and TH-BMD in DTC patients were all higher than those in controls at 1-year follow-up. The difference in FN-BMD was not significant after adjusting for baseline P1NP. In the postmenopausal women, no differences 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.

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Acknowledgements

We would like to thank all the participants of this study.

Author contributions

Y.L., Z.S., W.T., and H.Z. contributed to the study conception and design. Y.W., L.Z., M.L., and H.W. performed the study. S.W., L.H., Y.L., and F.Z. performed data analysis and interpretation. S.W. wrote the manuscript. Y.L. and Z.S. revised the manuscript. All authors have read and approved the final version of the manuscript.

Funding

This work was supported by the Distinguished Professor at Educational Department of Liaoning Province (No. [2015]153).

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, P. R. China

    Shiwei Wang, Yu Wang, Li Zhu, Haoyu Wang, Fan Zhang, Yaxin Lai, Yushu Li, Zhongyan Shan & Wei** Teng

  2. Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, P. R. China

    Liang He & Hao Zhang

  3. Department of Nuclear Medicine, The First Hospital of China Medical University, Shenyang, Liaoning, P. R. China

    Mutian Lv

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  1. Shiwei Wang
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Wang, S., Wang, Y., Zhu, L. et al. 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. Endocrine 79, 113–124 (2023). https://doi.org/10.1007/s12020-022-03186-6

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