engleski

Bone Loss in Premenopausal Women on Long-term Suppressive Therapy With Thyroid Hormone

BACKGROUND: It is controversial whether the long-term treatment with thyroid hormone given at suppressive doses has a negative effect on bone metabolism. The AIM of this prospective study was to determine whether the long-term thyroxine therapy in the premenopausal period is a risk factor for the development of secondary osteoporosis, and whether those women have increased bone loss during the premenopausal period. PATIENTS AND METODS: There were a selected group of women in premenopausal period (N=19) aging 39, 0ą8, 0 suffering from differentiated thyroid gland carcinoma. To all of them, the total thyreoidectomy was done and the thyroxine suppressive therapy was introduced. The duration of the suppressive therapy from the beginning of the research was 9, 4ą6, 4 years. Laboratory results have excluded other possible factors for secondary osteoporosis. The prospective study of bone densitometry was done during four years to all examinees using the method of dual photon x-ray absorptoimetry(DXA) of the spine and the femoral neck, and also by the method of single-photon absorptiometry (SPA) of the distal radius. RESULTS: In the beginning of this study, while the patients were treated for 10 years osteopenya was found in the spine and femoral neck in two examinees for every region. On the distal radius osteopenia was found in 4 examinees. The total was 8 out of 19 with osteopenia. One year later, after the second measurment no statisticaly significant loss of bone mass was in any region of sceleton. However, looking at the individual scores, osteopenya was found in 6 examinees on the distal radius but on the spine and the femoral neck there were bone loss in several women not to the point that would create osteopenia. But, after the 4 years of measurement t-test had shown some significant bone loss. CONCLUSION: And finaly, we can come to the decision that women who begin with a long-term thyroxine therapy (about 10 years) in the premenopausal period can develop osteopenia at the beginning of menopause. In that case, those women should complete mamography testing and bone densitometry before hormon replacement therapy is used.

thyroxine suppressive therapy; bone densitometry; thyroid carcinoma; osteopenia; prospective study

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