PMID- 29768627
OWN - NLM
STAT- MEDLINE
DCOM- 20180719
LR  - 20230423
IS  - 2359-4292 (Electronic)
IS  - 2359-3997 (Print)
IS  - 2359-3997 (Linking)
VI  - 62
IP  - 2
DP  - 2018 Mar-Apr
TI  - TSH-receptor antibodies may prevent bone loss in pre- and postmenopausal women 
      with Graves' disease and Graves' orbitopathy.
PG  - 221-226
LID - S2359-39972018000200221 [pii]
LID - 10.20945/2359-3997000000027 [doi]
AB  - OBJECTIVE: Thyrotoxicosis is established risk factor for osteoporosis due to 
      increased bone turnover. Glucocorticoids often administered for Graves' 
      orbitopathy (GO) have additional negative effect on bone mineral density (BMD). 
      Our aim was to examine the influence of thyroid hormones, TSH, TSH-receptor 
      antibodies (TRAb) and glucocorticoid treatment on bone in women with Graves' 
      thyrotoxicosis and Graves' orbitopathy (GO). SUBJECTS AND METHODS: Forty seven 
      women with Graves' disease, mean age 55.6 +/- 12.8 (23 women with thyrotoxicosis 
      and 24 hyperthyroid with concomitant GO and glucocorticoid therapy) and 40 
      age-matched healthy female controls were enrolled in the study. We analyzed 
      clinical features, TSH, FT4, FT3, TRAb, TPO antibodies. BMD of lumbar spine and 
      hip was measured by DEXA and 10-year fracture risk was calculated with FRAX tool. 
      RESULTS: The study showed significantly lower spine and femoral BMD (g/cm2) in 
      patients with and without GO compared to controls, as well as significantly 
      higher fracture risk. Comparison between hyperthyroid patients without and with 
      orbitopathy found out significantly lower spine BMD in the first group (p = 
      0.0049). Negative correlations between FT3 and femoral neck BMD (p = 0.0001), 
      between FT4 and BMD (p = 0.049) and positive between TSH and BMD (p = 0.0001), 
      TRAb and BMD (p = 0.026) were observed. Fracture risk for major fractures and 
      TRAb were negatively associated (p = 0.05). We found negative correlation of BMD 
      to duration of thyrotoxicosis and cumulative steroid dose. CONCLUSIONS: Our 
      results confirm the negative effect of hyperthyroid status on BMD. TRAb, often in 
      high titers in patients with GO, may have protective role for the bone, but 
      further research is needed.
FAU - Siderova, Mira
AU  - Siderova M
AD  - Clinic of Endocrinology and Metabolic Diseases, University Hospital "St. Marina", 
      Varna, Bulgaria.
FAU - Hristozov, Kiril
AU  - Hristozov K
AD  - Clinic of Endocrinology and Metabolic Diseases, University Hospital "St. Marina", 
      Varna, Bulgaria.
FAU - Tsukeva, Aleksandra
AU  - Tsukeva A
AD  - Department of Neurology and Neuroscience, University Hospital "St. Marina", 
      Varna, Bulgaria.
LA  - eng
PT  - Journal Article
PL  - Brazil
TA  - Arch Endocrinol Metab
JT  - Archives of endocrinology and metabolism
JID - 101652058
RN  - 0 (Glucocorticoids)
RN  - 0 (Immunoglobulins, Thyroid-Stimulating)
RN  - 0 (Thyroid Hormones)
RN  - 0 (thyrotropin-binding inhibitory immunoglobulin)
RN  - 9002-71-5 (Thyrotropin)
SB  - IM
MH  - Absorptiometry, Photon
MH  - Adult
MH  - Aged
MH  - Bone Density/drug effects/physiology
MH  - Case-Control Studies
MH  - Female
MH  - Fractures, Bone/etiology/physiopathology
MH  - Glucocorticoids/*adverse effects
MH  - Graves Disease/*complications/drug therapy/physiopathology
MH  - Graves Ophthalmopathy/*complications/drug therapy/physiopathology
MH  - Humans
MH  - Immunoglobulins, Thyroid-Stimulating/*physiology
MH  - Middle Aged
MH  - Osteoporosis, Postmenopausal/etiology/metabolism/*physiopathology
MH  - Reference Values
MH  - Risk Assessment
MH  - Risk Factors
MH  - Thyroid Hormones/*physiology
MH  - Thyrotoxicosis/complications/drug therapy/physiopathology
MH  - Thyrotropin/*physiology
PMC - PMC10118993
COIS- Disclosure: no potential conflict of interest relevant to this article was 
      reported.
EDAT- 2018/05/17 06:00
MHDA- 2018/07/20 06:00
PMCR- 2018/03/23
CRDT- 2018/05/17 06:00
PHST- 2016/08/10 00:00 [received]
PHST- 2016/12/23 00:00 [accepted]
PHST- 2018/05/17 06:00 [entrez]
PHST- 2018/05/17 06:00 [pubmed]
PHST- 2018/07/20 06:00 [medline]
PHST- 2018/03/23 00:00 [pmc-release]
AID - S2359-39972018000200221 [pii]
AID - 2359-3997000000027 [pii]
AID - 10.20945/2359-3997000000027 [doi]
PST - ppublish
SO  - Arch Endocrinol Metab. 2018 Mar-Apr;62(2):221-226. doi: 
      10.20945/2359-3997000000027.