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Do bone turnover markers reflect changes in bone microarchitecture during treatment of patients with thyroid dysfunction?

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Abstract

Purpose

This study aimed to compare changes in the bone turnover markers (BTMs)—C-terminal telopeptide of type I collagen (CTX-I) and procollagen I N-terminal peptide (PINP)—with changes in the bone microarchitecture, assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT), during treatment of patients with thyroid dysfunction.

Methods

In women with newly diagnosed hypo- or hyperthyroidism, HR-pQCT variables, obtained from the tibia and the radius, were compared with BTMs. Data were collected at diagnosis and after at least 12 months of euthyroidism.

Results

73 women completed the study (hypothyroidism, n = 27; hyperthyroidism, n = 46). Among hyperthyroid patients, correlations were found between changes in BTMs and HR-pQCT variables, primarily for cortical variables in the tibia, i.e. cortical thickness (CTX-I, p < 0.001; PINP, p < 0.001), and volumetric bone mass density (vBMD) (CTX-I, p < 0.001; PINP, p < 0.001). Moreover, correlations between BTMs and estimated bone strength were found. In the hypothyroid subgroup, no significant findings existed after adjustment. Following treatment, less decrease in tibial vBMD was seen among patients with increasing CTX-I compared to those with a decreasing CTX-I level (p = 0.009). Opposite findings applied to PINP, as patients with decreasing PINP showed an increase in tibial vBMD, in contrast to a decline in this parameter among patients with increasing PINP (p < 0.001).

Conclusion

Changes in CTX-I and PINP correlated with HR-pQCT variables during the treatment of women with thyroid dysfunction. To some extent, these BTMs reflected the restoration of bone microarchitecture. CTX-I seems to be the most sensitive BTM in treatment-naïve thyroid diseases, while PINP is more useful for monitoring during treatment.

Trial registration number

NCT02005250. Date: December 9, 2013.

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Data can be provided on request to the authors.

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Funding

This study received funding from “The Music Publishers Agnes and Knut Mørk’s Foundation”, from the “Danish Thyroid Federation”, and from research grants at Odense University Hospital.

Author information

Author notes

  1. Caroline Jeberg Vinther and Lotte Hvid Poulsen shared first authorship.

Authors and Affiliations

  1. Department of Endocrinology, Odense University Hospital, Odense, Denmark

    C. J. Vinther, L. H. Poulsen, P. Nicolaisen, M. L. Obling, T. H. Brix, A. P. Hermann, L. Hegedüs & S. J. Bonnema

  2. Department of Clinical Research, University of Southern Denmark, Odense, Denmark

    C. J. Vinther, L. H. Poulsen, P. Nicolaisen, M. L. Obling, T. H. Brix, A. P. Hermann, L. Hegedüs, N. R. Jørgensen & S. Hansen

  3. Department of Clinical Chemistry, Rigshospitalet, Glostrup, Denmark

    N. R. Jørgensen

  4. Department of Medicine, Hospital of South-West Jutland, Esbjerg, Denmark

    S. Hansen

  5. Department of Regional Health Research, University of Southern Denmark, Odense, Denmark

    S. Hansen

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  1. C. J. Vinther
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Corresponding author

Correspondence to S. J. Bonnema.

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The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by The Regional Research Ethics Committee of Southern Denmark (S-2011–0018).

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Informed consent was obtained from all individual participants included in the study.

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Vinther, C.J., Poulsen, L.H., Nicolaisen, P. et al. Do bone turnover markers reflect changes in bone microarchitecture during treatment of patients with thyroid dysfunction?. J Endocrinol Invest 46, 345–358 (2023). https://doi.org/10.1007/s40618-022-01907-2

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  • DOI: https://doi.org/10.1007/s40618-022-01907-2

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