, Volume 62, Issue 1, pp 166–173 | Cite as

Low trabecular bone score in postmenopausal women with differentiated thyroid carcinoma after long-term TSH suppressive therapy

  • María Luisa De Mingo Dominguez
  • Sonsoles Guadalix Iglesias
  • Cristina Martin-Arriscado Arroba
  • Begoña López Alvarez
  • Guillermo Martínez Diaz-Guerra
  • Jose Ignacio Martinez-Pueyo
  • Eduardo Ferrero Herrero
  • Federico Hawkins CarranzaEmail author
Original Article


The effect of thyroid suppression therapy (TST) on trabecular bone scores (TBS) and bone mineral density (BMD) in thyroidectomized women with differentiated thyroid carcinoma (DTC) on long-term follow-up is presently not conclusive. Patients and Methods. We carried out a study in 61 premenopausal and 84 postmenopausal Caucasian women with DTC. Serum biochemistry, bone markers, TBS, BMD, and bone fractures were evaluated 1–3 months post surgery and after a median follow-up of 10 years. Results. In the final study, patients belonged to Group I Premenopausal (n = 14) who remained in this status; Group II Premenopausal who became postmenopausal (n = 47); Group III patients who were and continued as postmenopausal (n = 84). Baseline premenopausal patients had a normal TBS mean value of 1.39 ± 0.14 significantly higher than that found in postmenopausal 1.31 ± 0.12 (p = 001). In the final study, premenopausal patients continued to have a normal TBS of 1.46 ± 0.08 compared to the significantly lower value of postmenopausal patients 1.25 ± 0.11 (p = 0.0009). Lumbar BMD (L-BMD) loss after the long-term study was significant in Group II (0.99 g/cm2 ± 0.13 vs. 0.91 ± 0.12 g/cm2, p < 0.0001) and there was a slight, but not significant, bone loss in Group I (1.00 ± 0.12 vs. 0.98 ± 0.11, p = 0.1936) and in Group III (0.86 ± 0.12 vs. 0.84 ± 0.15, p = 0.1924) compared with baseline values. Conclusion: Longer-term suppression therapy in female patients with DTC did not increase significantly the risk of bone loss, although we found in postmenopausal patients deterioration of bone microarchitecture. TBS study should be considered in the evaluation of postmenopausal DTC patients on long-term DTC for the evaluation of the risk of fractures.


Differentiated thyroid cancer Bone mineral density Trabecular bone score TSH suppression therapy 



The authors thank Dr. Fernando Marin, M.D., Ph.D., for valuable help in the preparation of the manuscript.


This study was supported by a grant from the Foundation for the Investigation of Osteoporosis and Endocrine Diseases, Spain.

Author contributions

Study design: F.H. and S.G. Study conduct: M.M., B.L., E.F., J.I.M. Data adquisition: M.M. Data analysis: C.A. Data interpretation: F.H., S.G., M.M., G.M. Drafting manuscript: F.H., S.G., M.M., B.L. Revising manuscript content and approving final version of the manuscript: F.H., S.G.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • María Luisa De Mingo Dominguez
    • 1
  • Sonsoles Guadalix Iglesias
    • 1
  • Cristina Martin-Arriscado Arroba
    • 2
  • Begoña López Alvarez
    • 3
  • Guillermo Martínez Diaz-Guerra
    • 1
  • Jose Ignacio Martinez-Pueyo
    • 4
  • Eduardo Ferrero Herrero
    • 4
  • Federico Hawkins Carranza
    • 1
    • 5
    Email author
  1. 1.Service of Endocrinology, University Hospital 12 de Octubre, Faculty of MedicineUniversity ComplutenseMadridSpain
  2. 2.Clinical Epidemiology & Research Institute i+12University Hospital 12 de OctubreMadridSpain
  3. 3.Centro de Salud GoyaMadridSpain
  4. 4.Endocrine Surgical Unit, University Hospital 12 de OctubreComplutense UniversityMadridSpain
  5. 5.Research Institute i+12University Hospital 12 de OctubreMadridSpain

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