title: Bone mass after long-term euthyroidism in former hyperthyroid women treated with (131)I influence of menopausal status.
abstract: The objective of this study was to assess bone mineral density (BMD) and bone markers in former hyperthyroid females after long-term euthyroidism (>4 yr) following (131)I therapy, as well as the potential influence of the timing of menopause. Twenty-six females ages 57 +/- 8 yr previously diagnosed with hyperthyroidism and treated with (131)I who were euthyroid for a minimum of the last 4 yr (10 +/- 5 yr) were studied. Eighteen patients (69%) were on levothyroxine (LT(4)) replacement therapy for 9 +/- 4 yr. BMD (g/cm(2) and Z-score) was measured by dual X-ray absorptiometry in the lumbar spine, femoral neck, and Ward's triangle. BMD (Z-score) was lower than the normal reference values for the Spanish population in all sites (lumbar spine: -0.65 +/- 1.13; femoral neck: -0.47 +/- 0.95; Ward's triangle: -0.37 +/- 0.88). No differences were found between BMD values according to the etiology of the hyperthyroidism or current LT(4) therapy. Current postmenopausal patients (n = 21) showed lower BMD than current premenopausal patients in the lumbar spine and femoral neck (p < 0.05). Those women who were postmenopausal at the time of the (131)I therapy (n = 15) also had lower lumbar spine BMD than premenopausal patients (p = 0.01), while no significant difference in BMD was seen according to the menopausal status when hyperthyroidism was diagnosed. Former hyperthyroid patients after long-term euthyroidism following (131)I therapy showed reduced BMD at the lumbar spine and proximal femur. Menopausal women showed a greater reduction in bone density. The menopausal status at the time of diagnosis did not seem to have long-term effects in bone density; nevertheless, an early therapeutic intervention in premenopause is suggested to reduce bone loss.
authors.affiliation: Service of Endocrinology and Nutrition, University Hospital, Madrid, Spain. fhawkins@hdoc.insalud.es
authors.forename: A
authors.initials: A
authors.lastname: Serraclara
authors.forename: E
authors.initials: E
authors.lastname: Jódar
authors.forename: F
authors.initials: F
authors.lastname: Sarabia
authors.forename: F
authors.initials: F
authors.lastname: Hawkins
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D015415:Biomarkers; D015992:Body Mass Index; D015519:Bone Density; D003430:Cross-Sectional Studies; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging; D006801:Humans; D006980:Hyperthyroidism / Q000503:physiopathology* / Q000628:therapy; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008593:Menopause / Q000502:physiology; D008875:Middle Aged; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood
chemical_list: D015415:Biomarkers; D007457:Iodine Radioisotopes; D013972:Thyrotropin; D013974:Thyroxine