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Endocrine, Metabolic & Immune Disorders - Drug Targets

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ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

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Research Article

Low Normal TSH Levels and Thyroid Autoimmunity are Associated with an Increased Risk of Osteoporosis in Euthyroid Postmenopausal Women

Author(s): Libo Yang, Hongmei Wang, Jinying Guo, Guanlin Zheng, Dailin Wei and Tie Zhang*

Volume 21, Issue 5, 2021

Published on: 10 August, 2020

Page: [859 - 865] Pages: 7

DOI: 10.2174/1871530320666200810144506

Price: $65

Abstract

Background and Objective: Studies on the relationship of thyroid stimulating hormone (TSH) within the reference range and thyroid autoimmunity with osteoporosis have produced conflicting results. The objective of this study was to investigate the association of thyroid function and thyroid autoimmune bodies (TPOAb and TgAb) with osteoporosis in euthyroid postmenopausal women.

Methods: A total of 174 subjects were retrospectively included. Serum TSH, total T3, total T4, TPOAb, TgAb, vitamin D, calcium and bone mineral density were measured. Correlation and logistic multivariate regression analysis were performed.

Results: Levels of TSH were lower in osteoporosis group (TSH: 2.03±1.08 vs 2.40±1.24 mIU/L, p=0.040) while TT3 and TT4 levels were similar between the two groups. The positive percentage of anti-TPO antibodies was higher in osteoporosis group (17.9% vs 6.7%, χ2= 5.13, p=0.024) while no significant difference was observed for anti-Tg antibodies (17.9% vs 8.9%, χ2=3.05, p=0.081). The Spearman correlation analysis showed that TSH levels were significantly correlated with lumbar spine BMD (r= 0.161, P=0.035) and femoral neck BMD (r = 0.152, P= 0.045). Logistical regression analysis revealed that low-normal TSH levels and positive TPOAb was an independent risk factor for osteoporosis (OR: 0.698, 95% CI: 0.505-0.965, p=0.030; OR: 3.961, 95% CI: 1.176-13.345, p=0.026 respectively).

Conclusion: The results showed that low-normal TSH levels and anti-TPO antibodies were independently associated with the presence of osteoporosis in postmenopausal women.

Keywords: Thyroid function, thyroid autoimmunity, TSH levels, osteoporosis, postmenopausal, women.

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[1]
Black, D.M.; Rosen, C.J. Clinical Practice. Postmenopausal Osteoporosis. N. Engl. J. Med., 2016, 374(3), 254-262.
[http://dx.doi.org/10.1056/NEJMcp1513724] [PMID: 26789873]
[2]
Curry, S.J.; Krist, A.H.; Owens, D.K.; Barry, M.J.; Caughey, A.B.; Davidson, K.W.; Doubeni, C.A.; Epling, J.W., Jr; Kemper, A.R.; Kubik, M.; Landefeld, C.S.; Mangione, C.M.; Phipps, M.G.; Pignone, M.; Silverstein, M.; Simon, M.A.; Tseng, C.W.; Wong, J.B. US Preventive Services Task Force. Screening for Osteoporosis to Prevent Fractures: US Preventive Services Task Force Recommendation Statement. JAMA, 2018, 319(24), 2521-2531.
[http://dx.doi.org/10.1001/jama.2018.7498] [PMID: 29946735]
[3]
Blum, M.R.; Bauer, D.C.; Collet, T.H.; Fink, H.A.; Cappola, A.R.; da Costa, B.R.; Wirth, C.D.; Peeters, R.P.; Åsvold, B.O.; den Elzen, W.P.; Luben, R.N.; Imaizumi, M.; Bremner, A.P.; Gogakos, A.; Eastell, R.; Kearney, P.M.; Strotmeyer, E.S.; Wallace, E.R.; Hoff, M.; Ceresini, G.; Rivadeneira, F.; Uitterlinden, A.G.; Stott, D.J.; Westendorp, R.G.; Khaw, K.T.; Langhammer, A.; Ferrucci, L.; Gussekloo, J.; Williams, G.R.; Walsh, J.P.; Jüni, P.; Aujesky, D.; Rodondi, N. Thyroid Studies Collaboration. Subclinical thyroid dysfunction and fracture risk: a meta-analysis. JAMA, 2015, 313(20), 2055-2065.
[http://dx.doi.org/10.1001/jama.2015.5161] [PMID: 26010634]
[4]
Leader, A.; Ayzenfeld, R.H.; Lishner, M.; Cohen, E.; Segev, D.; Hermoni, D. Thyrotropin levels within the lower normal range are associated with an increased risk of hip fractures in euthyroid women, but not men, over the age of 65 years. J. Clin. Endocrinol. Metab., 2014, 99(8), 2665-2673.
[http://dx.doi.org/10.1210/jc.2013-2474] [PMID: 24885627]
[5]
Svare, A.; Nilsen, T.I.; Asvold, B.O.; Forsmo, S.; Schei, B.; Bjøro, T.; Langhammer, A. Does thyroid function influence fracture risk? Prospective data from the HUNT2 study, Norway. Eur. J. Endocrinol., 2013, 169(6), 845-852.
[http://dx.doi.org/10.1530/EJE-13-0546] [PMID: 24031093]
[6]
Murphy, E.; Glüer, C.C.; Reid, D.M.; Felsenberg, D.; Roux, C.; Eastell, R.; Williams, G.R. Thyroid function within the upper normal range is associated with reduced bone mineral density and an increased risk of nonvertebral fractures in healthy euthyroid postmenopausal women. J. Clin. Endocrinol. Metab., 2010, 95(7), 3173-3181.
[http://dx.doi.org/10.1210/jc.2009-2630] [PMID: 20410228]
[7]
Mazziotti, G.; Porcelli, T.; Patelli, I.; Vescovi, P.P.; Giustina, A. Serum TSH values and risk of vertebral fractures in euthyroid post-menopausal women with low bone mineral density. Bone, 2010, 46(3), 747-751.
[http://dx.doi.org/10.1016/j.bone.2009.10.031] [PMID: 19892039]
[8]
Kim, B.J.; Lee, S.H.; Bae, S.J.; Kim, H.K.; Choe, J.W.; Kim, H.Y.; Koh, J.M.; Kim, G.S. The association between serum thyrotropin (TSH) levels and bone mineral density in healthy euthyroid men. Clin. Endocrinol. (Oxf.), 2010, 73(3), 396-403.
[http://dx.doi.org/10.1111/j.1365-2265.2010.03818.x] [PMID: 20455884]
[9]
Lambrinoudaki, I.; Armeni, E.; Pliatsika, P.; Rizos, D.; Kaparos, G.; Augoulea, A.; Alexandrou, A.; Flokatoula, M.; Creatsa, M.; Panoulis, C.; Triantafyllou, N.; Papacharalambous, X. Thyroid function and autoimmunity are associated with the risk of vertebral fractures in postmenopausal women. J. Bone Miner. Metab., 2017, 35(2), 227-233.
[http://dx.doi.org/10.1007/s00774-016-0752-0] [PMID: 27023333]
[10]
Polovina, S.P.; Miljic, D.; Zivojinovic, S.; Milic, N.; Micic, D.; Brkic, V.P. The impact of thyroid autoimmunity (TPOAb) on bone density and fracture risk in postmenopausal women. Hormones (Athens), 2017, 16(1), 54-61.
[PMID: 28500828]
[11]
Iseme, R.A.; McEvoy, M.; Kelly, B.; Agnew, L.; Walker, F.R.; Boyle, M.; Attia, J. A Cross-Sectional Study of the Association between Autoantibodies and Qualitative Ultrasound Index of Bone in an Elderly Sample without Clinical Autoimmune Disease. J. Immunol. Res., 2018, 20189407971
[http://dx.doi.org/10.1155/2018/9407971] [PMID: 29854851]
[12]
Shi, Y.; Sun, M.; Wang, Z.; Fu, Q.; Cao, M.; Zhu, Z.; Meng, C.; Mao, J.; Duan, Y.; Tang, W.; Huang, X.; Lu, J.; Bi, Y.; Ning, G.; He, W.; Yang, T. Association between calcaneus quantitative ultrasound (QUS) parameters and thyroid status in middle-aged and elderly Chinese men with euthyroidism: a population-based cross-sectional study. Endocrine, 2014, 47(1), 227-233.
[http://dx.doi.org/10.1007/s12020-013-0147-0] [PMID: 24464689]
[13]
Acar, B.; Ozay, A.C.; Ozay, O.E.; Okyay, E.; Sisman, A.R.; Ozaksoy, D. Evaluation of thyroid function status among postmenopausal women with and without osteoporosis. Int. J. Gynaecol. Obstet., 2016, 134(1), 53-57.
[http://dx.doi.org/10.1016/j.ijgo.2015.11.025] [PMID: 27177516]
[14]
Noh, H.M.; Park, Y.S.; Lee, J.; Lee, W. A cross-sectional study to examine the correlation between serum TSH levels and the osteoporosis of the lumbar spine in healthy women with normal thyroid function. Osteoporos. Int., 2015, 26(3), 997-1003.
[http://dx.doi.org/10.1007/s00198-014-2906-z] [PMID: 25253541]
[15]
Abe, E.; Marians, R.C.; Yu, W.; Wu, X.B.; Ando, T.; Li, Y.; Iqbal, J.; Eldeiry, L.; Rajendren, G.; Blair, H.C.; Davies, T.F.; Zaidi, M. TSH is a negative regulator of skeletal remodeling. Cell, 2003, 115(2), 151-162.
[http://dx.doi.org/10.1016/S0092-8674(03)00771-2] [PMID: 14567913]
[16]
Sun, L.; Davies, T.F.; Blair, H.C.; Abe, E.; Zaidi, M. TSH and bone loss. Ann. N. Y. Acad. Sci., 2006, 1068, 309-318.
[http://dx.doi.org/10.1196/annals.1346.033] [PMID: 16831931]
[17]
Baliram, R.; Latif, R.; Zaidi, M.; Davies, T.F. Expanding the Role of Thyroid-Stimulating Hormone in Skeletal Physiology. Front. Endocrinol. (Lausanne), 2017, 8, 252.
[http://dx.doi.org/10.3389/fendo.2017.00252] [PMID: 29042858]
[18]
Bugatti, S.; Bogliolo, L.; Montecucco, C.; Manzo, A. B cell autoimmunity and bone damage in rheumatoid arthritis. Reumatismo, 2016, 68(3), 117-125.
[http://dx.doi.org/10.4081/reumatismo.2016.914] [PMID: 27981813]
[19]
Heikkilä, K.; Heliövaara, M.; Impivaara, O.; Kröger, H.; Knekt, P.; Rissanen, H.; Mäki, M.; Kaukinen, K. Celiac disease autoimmunity and hip fracture risk: findings from a prospective cohort study. J. Bone Miner. Res., 2015, 30(4), 630-636.
[http://dx.doi.org/10.1002/jbmr.2380] [PMID: 25270967]
[20]
Mak, A.; Lim, J.Q.; Liu, Y.; Cheak, A.A.; Ho, R.C. Significantly higher estimated 10-year probability of fracture in lupus patients with bone mineral density comparable to that of healthy individuals. Rheumatol. Int., 2013, 33(2), 299-307.
[http://dx.doi.org/10.1007/s00296-012-2389-1] [PMID: 22441963]
[21]
Antonelli, A.; Ferrari, S.M.; Corrado, A.; Di Domenicantonio, A.; Fallahi, P. Autoimmune thyroid disorders. Autoimmun. Rev., 2015, 14(2), 174-180.
[http://dx.doi.org/10.1016/j.autrev.2014.10.016] [PMID: 25461470]
[22]
Colin, I.M.; Isaac, J.; Dupret, P.; Ledant, T.; D’Hautcourt, J.L. Functional lymphocyte subset assessment of the Th1/Th2 profile in patients with autoimmune thyroiditis by flowcytometric analysis of peripheral lymphocytes. J. Biol. Regul. Homeost. Agents, 2004, 18(1), 72-76.
[PMID: 15323363]
[23]
Weitzmann, M.N. Bone and the Immune System. Toxicol. Pathol., 2017, 45(7), 911-924.
[http://dx.doi.org/10.1177/0192623317735316] [PMID: 29046115]
[24]
Siderova, M.; Hristozov, K.; Tsukeva, A. TSH-receptor antibodies may prevent bone loss in pre- and postmenopausal women with Graves’ disease and Graves’ orbitopathy. Arch. Endocrinol. Metab., 2018, 62(2), 221-226.
[http://dx.doi.org/10.20945/2359-3997000000027] [PMID: 29768627]
[25]
Belsing, T.Z.; Tofteng, C.; Langdahl, B.L.; Charles, P.; Feldt-Rasmussen, U. Can bone loss be reversed by antithyroid drug therapy in premenopausal women with Graves’ disease? Nutr. Metab. (Lond.), 2010, 7, 72.
[http://dx.doi.org/10.1186/1743-7075-7-72] [PMID: 20807449]
[26]
Ke, W.; Sun, T.; Zhang, Y.; He, L.; Wu, Q.; Liu, J.; Zha, B. 25-Hydroxyvitamin D serum level in Hashimoto’s thyroiditis, but not Graves’ disease is relatively deficient. Endocr. J., 2017, 64(6), 581-587.
[http://dx.doi.org/10.1507/endocrj.EJ16-0547] [PMID: 28413173]
[27]
Kim, C.Y.; Lee, Y.J.; Choi, J.H.; Lee, S.Y.; Lee, H.Y.; Jeong, D.H.; Choi, Y.J. The Association between Low Vitamin D Status and Autoimmune Thyroid Disease in Korean Premenopausal Women: The 6th Korea National Health and Nutrition Examination Survey, 2013-2014. Korean J. Fam. Med., 2019, 40(5), 323-328.
[http://dx.doi.org/10.4082/kjfm.18.0075] [PMID: 31476853]

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