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Bone mineral density and bone fracture in male patients receiving long-term suppressive levothyroxine treatment for differentiated thyroid carcinoma

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Abstract

Studies on the effect of exogenous subclinical thyrotoxicosis on bone mineral density (BMD) in male patients treated with suppressive doses of levothyroxine for differentiated thyroid carcinoma (DTC) are not conclusive. In order to evaluate BMD (in femoral neck, lumbar spine, and distal radius) and bone fractures in men under long-term suppressive treatment with levothyroxine for DTC, we conducted a cross-sectional, retrospective study in 33 Caucasian men (mean ± SD age: 56 ± 14 years) under treatment for DTC. The control group comprised 33 healthy age- and body mass index-matched male volunteers. BMD was assessed by dual-energy X-ray absorptiometry (DXA). Bone turnover biomarkers (calcium, phosphate, alkaline phosphatase, PTH, vitamin D, urinary calcium, and N-Telopeptide/creatinine index) and testosterone were determined. Previous bone fractures were evaluated with a questionnaire and X-ray images of thoracic and lumbar vertebrae. Patients were treated for a mean duration of 15 ± 5 years. No differences were found between patients and controls in bone turnover biomarkers or areal BMD, T-scores or Z-scores in all sites evaluated. No earlier fractures or pain episodes were registered in either group and the incidence of asymptomatic vertebral fractures did not differ significantly between patient (18.8%) and control groups (16.7%), (P = 0.9). In conclusion, long-term suppressive treatment with levothyroxine in men with DTC does not appear to exert deleterious effects on bone mineral density or increase the prevalence of fracture.

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Acknowledgments

The authors thank Mr David Duatis for his collaboration in the DXA procedures and Ms Christine O’Hara for her valuable contribution to the preparation of the manuscript.

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Authors and Affiliations

  1. Department of Endocrinology and Nutrition, Germans Trias i Pujol University Hospital, Via Canyet s/n, 08916, Badalona, Barcelona, Spain

    Jordi L. Reverter, Eulàlia Colomé, Eva Aguilera, Berta Soldevila & Anna Sanmartí

  2. Departament de Medicina, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain

    Jordi L. Reverter, Eulàlia Colomé, Eva Aguilera, Berta Soldevila & Anna Sanmartí

  3. Department of Rheumatology, Germans Trias i Pujol University Hospital, Via Canyet s/n, 08916, Badalona, Barcelona, Spain

    Susana Holgado & Lourdes Mateo

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  1. Jordi L. Reverter
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  2. Eulàlia Colomé
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  3. Susana Holgado
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Correspondence to Jordi L. Reverter.

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Reverter, J.L., Colomé, E., Holgado, S. et al. Bone mineral density and bone fracture in male patients receiving long-term suppressive levothyroxine treatment for differentiated thyroid carcinoma. Endocr 37, 467–472 (2010). https://doi.org/10.1007/s12020-010-9339-z

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  • DOI: https://doi.org/10.1007/s12020-010-9339-z

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