title: Bone and calcium metabolism in subclinical autoimmune hyperthyroidism and hypothyroidism.
abstract: Bone turnover is reported to increase in favour of resorption in overt hyperthyroidism and the rate of resorption is associated with the levels of thyroid hormones. Hypothyroidism, on the other hand, was shown to cause no disturbance of calcium kinetics and found to associate lower trabecular resorption surfaces and increased bone cortical thickness. Similar studies are very rare in subclinical thyroid disorders and consequently we aimed to examine calcium and bone metabolism in subclinical thyroid disorders. Thirteen patients with subclinical hyperthyroidism secondary to untreated Graves' disease, 20 patients with subclinical hypothyroidism and 10 healthy subjects participated in this survey. Briefly calcium, phosphorus, and creatinine (Cre), urinary deoxypyridinoline (U-DPD) and serum osteocalcin (OC) were measured as biochemical markers for calcium metabolism. Concerning serum Ca and phosphorus levels, there were no differences between three of the groups, but urinary Ca excretion was higher in subclinical hyperthyroid patients compared to control and hypothyroid subjects. Hypothyroid patients had similar U-DPD levels with control subjects (p = 0.218). Serum OC and U-DPD were higher in subclinical hyperthyroid compared to control subjects (p<0.001 and p<0.001 respectively). We demonstrated a higher bone turnover and greater calcium excretion in subclinical hyperthyroid patients. Additionally, we found that subclinical hypothyroidism is not associated with disturbed calcium metabolism. As persistent increase in bone turnover is responsible for accelerated bone loss, patients with Graves' disease may have increased risk for osteoporosis.
authors.affiliation: Department of Internal Medicine, Divisions of Endocrinology, Meram Medical Faculty, Selcuk University, Konya, Turkey.
authors.forename: Gurcan
authors.initials: G
authors.lastname: Kisakol
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kaya
authors.forename: Sait
authors.initials: S
authors.lastname: Gonen
authors.forename: Recep
authors.initials: R
authors.lastname: Tunc
mesh_terms: D000328:Adult; D000596:Amino Acids / Q000652:urine; D001327:Autoimmune Diseases / Q000097:blood / Q000378:metabolism* / Q000503:physiopathology / Q000652:urine; D015415:Biomarkers / Q000032:analysis; D016723:Bone Remodeling; D001842:Bone and Bones / Q000378:metabolism*; D002118:Calcium / Q000378:metabolism* / Q000652:urine; D016022:Case-Control Studies; D005260:Female; D006111:Graves Disease / Q000097:blood / Q000378:metabolism* / Q000503:physiopathology / Q000652:urine; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000378:metabolism* / Q000652:urine; D008297:Male; D013963:Thyroid Hormones / Q000097:blood
chemical_list: D000596:Amino Acids; D015415:Biomarkers; D013963:Thyroid Hormones; C036020:deoxypyridinoline; D002118:Calcium