SFEIES24 Poster Presentations Bone & Calcium (20 abstracts)
Assessment of bone mineral metabolism in patients with differentiated thyroid cancer
Carmen Sorina Martin 1,2 , Ioana Simona Afrasinei 1 , Oana Stefana Enache 1 , Iulia Stoian 1,2 , Luminita Cima 1,2 , Anca Elena Sirbu 1,2 , Carmen Gabriela Barbu 1,2 & Simona Fica 1,2
1“Carol Davila” University of Medicine and Pharmacy, Department of Endocrinology, Diabetes, Nutrition and Metabolic Disorders, Bucharest, Romania; 2Elias Hospital, Department of Endocrinology, Diabetes Mellitus, Nutrition and Metabolic Disorders, Bucharest, Romania
In 2022, the 5-year prevalence of thyroid cancer in Romania was 2.1/100.000. Differentiated thyroid cancer (DTC), the predominant form, often necessitates surgery and TSH suppressive therapy (TST). If severe and prolonged, this may accelerate bone remodelling, resulting in osteoporosis and increased fracture risk. This retrospective study aimed to assess the impact of TST on bone metabolism in a cohort of DTC patients. We analyzed: age, menopausal status, degree, and duration of TST, lumbar spine and hip bone mineral density (BMD), lumbar spine TBS, and FRAX fracture risk. We reviewed 148 DTC patients admitted between 2018-2023, followed up for 4.60±3.46 years, out of which 62 underwent a bone density (DXA) scan, 27 having multiple examinations. 82% were overweight or obese, with a mean age at DTC diagnosis of 55.61±12.11 years. 92% were women, 44 being postmenopausal (PM). 66% had osteopenia or osteoporosis and 7 had prior fragility fractures. Additionally, 46% exhibited low lumbar spine TBS, indicating compromised bone microarchitecture. The PM group has significantly lower mean BMD(P = 0.004) and T score(P = 0.008) in the femoral neck compared to premenopausal women. Dynamic evaluation revealed that higher TSH levels correlated with increased BMD in the lumbar spine (P = 0.026) and femoral neck(P = 0.028). Patients with TST had significantly lower mean BMD(P = 0.008), T(P = 0.012) and Z scores(P = 0.007) in the lumbar spine compared to those without suppression. Similar trends were observed in the femoral neck for the group with TSH<0.1mIU/l compared to those with moderate(P = 0.052) or without suppression(P = 0.047). We found negative correlations between the duration of TST and most DXA parameters in the femoral neck, while in the lumbar spine only with TBS. In conclusion, TSH suppression may impact bone metabolism, particularly in postmenopausal patients or those already having osteoporosis. Future prospective studies with larger patient cohorts could optimize patient care.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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