Fracture risk in patients treated for hyperthyroidism.
OBJECTIVE
To study fracture risk and risk factors for fractures in patients with hyperthyroidism.


METHODS
Historical follow-up.


METHODS
A total of 864 patients with diffuse toxic goiter (ICD 10: E05.0) or toxic nodular goiter (E05.2) were contacted through a self-administered questionnaire. Each respondent was compared to an age: (+/- 5 years) and gender-matched control from a random sample of the background population who responded to the same questionnaire.


RESULTS
Among the patients 621 (72%) responded and of these 617 could be analyzed. Within the first 5 years before the diagnosis, the patients had the same fracture risk as the controls (RR = 1.2, 95% CI; 0.7-2.0). After the diagnosis, fracture risk was elevated among the patients (RR = 1.7, 95% CI: 1.2-2.3), especially in the age group 50 years or older (RR = 2.2, 95% CI: 1.5-3.3). Fracture risk was elevated for fractures of the spine (RR = 8.9, 95% CI: 1.6-48.4), and the forearms (RR = 3.1, 95% CI: 1.6-6.2), but not at other skeletal sites. Treatment with radioactive iodine alone was associated with an increased fracture risk (OR = 2.7, 95% CI: 1.2-6.0), a risk that was not present in patients who, in addition to radioactive iodine, also had received methimazole (RR = 1.5, 95% CI: 0.7-3.2).


CONCLUSIONS
Our study demonstrated an increased fracture risk in hyperthyroidism, a fracture risk that was present with radioactive iodine treatment alone, but not in subjects that had received both radioactive iodine and methimazole or other types of antithyroid therapy.
Vestergaard
P
P
The Osteoporosis Clinic, Aarhus Amtssygehus, Aarhus University Hospital, Denmark. p-vest@post4.tele.dk
Rejnmark
L
L
Weeke
J
J
Mosekilde
L
L
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D013956:Antithyroid Agents / Q000009:adverse effects; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000209:etiology*; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications* / Q000628:therapy; D007457:Iodine Radioisotopes / Q000009:adverse effects; D008297:Male; D008713:Methimazole / Q000009:adverse effects; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires
D013956:Antithyroid Agents; D007457:Iodine Radioisotopes; D008713:Methimazole