Skip to main content
SpringerLink
Log in

Higher prevalence of thyroid-specific autoantibodies (TPOAb and TgAb) is related to a higher prevalence of fractures in females: results from NHANES 2007–2010

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

A retrospective analysis was conducted using data from the NHANES. Bone mineral density (BMD) was compared in different thyroid-specific autoantibodies groups. Strengths of associations were calculated by using binary logistic regression models. Higher titers of thyroid-specific autoantibodies (TgAb and/or TPOAb) may lead to decreased BMD. Higher prevalence of TgAb and TPOAb significantly associated with fractures in females but not in males.

Purpose

Hashimoto’s thyroiditis is characterized by elevated thyroid-specific autoantibodies. It is currently believed that osteoporosis is not only a disease with abnormal mineral metabolism but also with immune abnormalities. This study investigated the relationship between thyroid-specific autoantibodies and osteoporosis, including the bone mineral density (BMD) values and fractures.

Methods

A retrospective analysis was conducted using data from the National Health and Nutrition Examination Survey (2007–2010). BMD was compared in different thyroid-specific autoantibodies groups. The associations between thyroid-specific autoantibodies and fractures were explored. Strengths of associations were calculated by binary logistic regression models. Candidate variables for binary logistic regression model were selected after screened in univariate analysis (variables with P < 0.05).

Results

A total of 3865 study participants were included in this analysis; 224 participants were TgAb positive and 356 were TPOAb positive. A total of 392 participants reported hip, spine or wrist fractures. Participants with higher prevalence of TgAb or TPOAb had lower BMD. In females, significant cigarettes use, higher prevalence of TgAb and TPOAb, and the BMD of the total femur and femoral neck were significantly associated with fractures. Higher prevalence of TPOAb was particularly associated with a higher possibility of hip or spine fractures. In males, significant cigarettes use, 25OHD3, the BMD values of the total femur, femoral neck and total spine were significantly associated with fractures.

Conclusion

Higher prevalence of thyroid-specific autoantibodies may lead to decreased BMD. In females, higher prevalence of TgAb and TPOAb significantly associated with fractures and TPOAb especially relating to the fractures of hip and spine. Males patients with vitamin D deficiency or insufficiency associated a higher possibility of fractures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Reid IR, Billington EO (2022) Drug therapy for osteoporosis in older adults. The Lancet 399(10329):1080–1092. https://doi.org/10.1016/S0140-6736(21)02646-5

    Article  CAS  Google Scholar 

  2. Arron JR, Choi Y (2000) Bone versus immune system. Nature 408(6812):535–536. https://doi.org/10.1038/35046196

    Article  CAS  PubMed  Google Scholar 

  3. Bone HG et al (2017) 10 years of denosumab treatment in postmenopausal women with osteoporosis: results from the phase 3 randomised FREEDOM trial and open-label extension. Lancet Diabetes Endocrinol 5(7):513–523. https://doi.org/10.1016/S2213-8587(17)30138-9

    Article  CAS  PubMed  Google Scholar 

  4. Wu J, Huang H, Yu X (2023) How does Hashimoto’s thyroiditis affect bone metabolism? Rev Endocr Metab Disord 24(2):191–205. https://doi.org/10.1007/s11154-022-09778-x

    Article  PubMed  Google Scholar 

  5. Antonelli A, Ferrari SM, Corrado A, Di Domenicantonio A, Fallahi P (2015) Autoimmune thyroid disorders. Autoimmun Rev 14(2):174–180. https://doi.org/10.1016/j.autrev.2014.10.016

    Article  CAS  PubMed  Google Scholar 

  6. Ralli M et al (2020) Hashimoto’s thyroiditis: An update on pathogenic mechanisms, diagnostic protocols, therapeutic strategies, and potential malignant transformation. Autoimmun Rev 19(10):102649. https://doi.org/10.1016/j.autrev.2020.102649

    Article  CAS  PubMed  Google Scholar 

  7. Li Y et al (2018) Impact of healthy lifestyle factors on life expectancies in the US population. Circulation 138(4):345–355. https://doi.org/10.1161/CIRCULATIONAHA.117.032047

    Article  PubMed  PubMed Central  Google Scholar 

  8. Wolffenbuttel BHR, Heiner-Fokkema MR, Green R, Gans ROB (2020) Relationship between serum B12 concentrations and mortality: experience in NHANES. BMC Med 18(1):307. https://doi.org/10.1186/s12916-020-01771-y

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. NHANES (2007–2008) Procedure Manuals: Centers for Disease Control and Prevention (CDC). Available online at: https://wwwn.cdc.gov/nchs/nhanes/continuousnhanes/manuals.aspx?BeginYear=2007. [Online]. Available: Available online at: https://wwwn.cdc.gov/nchs/nhanes/continuousnhanes/manuals.aspx?BeginYear=2007

  10. NHANES (2007–2008) Examination Data: Centers for Disease Control and Prevention (CDC). Available online at: https://wwwn.cdc.gov/nchs/nhanes/search/datapage.aspx?Component=Examination&CycleBeginYear=2007

  11. Bondy SJ, Victor JC, Diemert LM (2009) Origin and use of the 100 cigarette criterion in tobacco surveys. Tob Control 18(4):317–323. https://doi.org/10.1136/tc.2008.027276

    Article  CAS  PubMed  Google Scholar 

  12. Levy DT et al (2019) Measuring smoking prevalence in a middle income nation: An examination of the 100 cigarettes lifetime screen. Glob Epidemiol 1:100016. https://doi.org/10.1016/j.gloepi.2019.100016

    Article  PubMed  Google Scholar 

  13. Ryan H, Trosclair A, Gfroerer J (2012) Adult Current Smoking: Differences in Definitions and Prevalence Estimates—NHIS and NSDUH, 2008. J Environ Public Health 2012:1–11. https://doi.org/10.1155/2012/918368

    Article  Google Scholar 

  14. Centers for Disease Control and Prevention (n.d.) Adult Alcohol Use Information. Available from: https://www.cdc.gov/nchs/nhis/alcohol/alcohol_glossary.htm. Accessed 10 Aug 2020

  15. Pagnotti GM et al (2019) Combating osteoporosis and obesity with exercise: leveraging cell mechanosensitivity. Nat Rev Endocrinol 15(6):339–355. https://doi.org/10.1038/s41574-019-0170-1

    Article  PubMed  PubMed Central  Google Scholar 

  16. on behalf of the Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF), Kanis JA, Cooper C, Rizzoli R, Reginster J-Y (2019) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 30(1):3–44. https://doi.org/10.1007/s00198-018-4704-5

  17. Tramontana F et al (2024) More rapid bone mineral density loss in older men with diabetes: The Osteoporotic Fractures in Men (MrOS) Study. J Clin Endocrinol Metab :dgae045. https://doi.org/10.1210/clinem/dgae045

  18. Xiao P-L et al (2022) Global, regional prevalence, and risk factors of osteoporosis according to the World Health Organization diagnostic criteria: a systematic review and meta-analysis. Osteoporos Int 33(10):2137–2153. https://doi.org/10.1007/s00198-022-06454-3

    Article  PubMed  Google Scholar 

  19. Polovina SP, Miljic D, Zivojinovic S, Milic N, Micic D, Brkic VP (2017) The impact of thyroid autoimmunity (TPOAb) on bone density and fracture risk in postmenopausal women. Hormones 16(1):54–61. https://doi.org/10.14310/horm.2002.1719

  20. Lambrinoudaki I et al (2017) Thyroid function and autoimmunity are associated with the risk of vertebral fractures in postmenopausal women. J Bone Miner Metab 35(2):227–233. https://doi.org/10.1007/s00774-016-0752-0

    Article  CAS  PubMed  Google Scholar 

  21. Polovina S, Popovic V, Duntas L, Milic N, Micic D (2013) Frax score calculations in postmenopausal women with subclinical hypothyroidism. Hormones 12(3):439–448. https://doi.org/10.1007/BF03401309

    Article  PubMed  Google Scholar 

  22. Święchowicz B, Kasielska-Trojan A, Manning JT, Antoszewski B (2022) Can digit ratio (2D:4D) Be indicative of predispositions to autoimmune thyroid diseases in women - Hashimoto thyroiditis and Graves’ disease? Front Endocrinol 13:914471. https://doi.org/10.3389/fendo.2022.914471

    Article  Google Scholar 

  23. Shih Y-RV et al (2019) Dysregulation of ectonucleotidase-mediated extracellular adenosine during postmenopausal bone loss. Sci Adv 5(8):eaax1387. https://doi.org/10.1126/sciadv.aax1387

  24. Ragusa F et al (2019) Hashimotos’ thyroiditis: Epidemiology, pathogenesis, clinic and therapy. Best Pract Res Clin Endocrinol Metab 33(6):101367. https://doi.org/10.1016/j.beem.2019.101367

    Article  PubMed  Google Scholar 

  25. Law MR, Hackshaw AK (1997) A meta-analysis of cigarette smoking, bone mineral density and risk of hip fracture: recognition of a major effect. BMJ 315(7112):841–846. https://doi.org/10.1136/bmj.315.7112.841

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Yin X et al (2022) Association between vitamin D serum levels and insulin resistance assessed by HOMA-IR among non-diabetic adults in the United States: Results from NHANES 2007–2014. Front Nutr 9:883904. https://doi.org/10.3389/fnut.2022.883904

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Gregson CL et al (2022) UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos 17(1):58. https://doi.org/10.1007/s11657-022-01061-5

    Article  PubMed  PubMed Central  Google Scholar 

  28. Viscoli CM et al (2016) Pioglitazone and risk for bone fracture: safety data from a randomized clinical trial. J Clin Endocrinol Metab:jc.2016–3237. https://doi.org/10.1210/jc.2016-3237

  29. Sahrai MS et al (2022) Determinants of obesity and metabolic health in the Afghan population: protocol, methodology, and preliminary results. J Epidemiol Glob Health 12(1):113–123. https://doi.org/10.1007/s44197-021-00026-0

    Article  PubMed  PubMed Central  Google Scholar 

  30. Muschitz C et al (2022) Epidemiology and economic burden of fragility fractures in Austria. Osteoporos Int 33(3):637–647. https://doi.org/10.1007/s00198-021-06152-6

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

This work was supported by grants from the National Natural Science Foundation of China (No. 82273294), the Science and Technology Department of Sichuan Province (2022YFS0136), the Chengdu Bureau of Science and Technology (2022-YF05-01316-SN), Sichuan University (No. 2018SCUH0093), and the 1.3.5 project for discipline of excellence, West China Hospital, Sichuan University (No. 2020HXFH008, No. ZYJC18003).

Author information

Authors and Affiliations

  1. Laboratory of Endocrinology and Metabolism/ Department of Endocrinology and Metabolism, Rare Disease Center, West China Hospital, Sichuan University, No. 37, Guoxue Xiang, Chengdu, 610041, China

    Jialu Wu, Jian Li & Xijie Yu

  2. Department of Endocrinology, Shandong Second Provincial General Hospital, Jinan, 250022, People’s Republic of China

    Jian Li

  3. Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, No. 37, Guoxue Xiang, Chengdu, 610041, China

    Zhe Yan & Hui Huang

Authors
  1. Jialu Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jian Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zhe Yan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xijie Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hui Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Xijie Yu or Hui Huang.

Ethics declarations

Conflict of interest

None.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 23 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wu, J., Li, J., Yan, Z. et al. Higher prevalence of thyroid-specific autoantibodies (TPOAb and TgAb) is related to a higher prevalence of fractures in females: results from NHANES 2007–2010. Osteoporos Int (2024). https://doi.org/10.1007/s00198-024-07083-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00198-024-07083-8

Keywords

Search

Navigation