Recombinant human thyroid stimulating hormone does not acutely change serum osteoprotegerin and soluble receptor activator of nuclear factor-kappaBeta ligand in patients under evaluation for differentiated thyroid carcinoma.
OBJECTIVE
Some extra-thyroid actions of thyroid stimulating hormone (TSH), such as an in vitro action on bone, have been described. Our aim was to evaluate in vivo the acute effect of a recombinant human TSH (rhTSH)-induced TSH surge on Osteoprotegerin (OPG) and receptor activator of the nuclear factor-kappaBeta (RANK-L) levels in patients under levo-thyroxine (L-T4) therapy.


METHODS
24 patients with differentiated thyroid carcinoma (DTC) were studied. Standard rhTSH testing was performed. OPG, RANK-L, TSH, thyroid hormones, thyroglobulin and several parameters of bone metabolism were evaluated.


RESULTS
Baseline OPG and RANK-L levels were in the range of our reference population. An inverse correlation between OPG and spinal Z-score (p=0.029) and between RANK-L and age (p=0.018) or urinary calcium/creatinine ratio (p=0.011) was detected. After rhTSH administration, a significant (p<0.001) increase in TSH was found. No significant increase in OPG or RANK-L levels after rhTSH was observed. No correlation was detected between TSH peak value after rhTSH and maximal percentage change in OPG or RANK-L. A slight increase in urinary cross-links after rhTSH was found.


CONCLUSIONS
In a small group of subjects with a history of DTC on L-T4 regimen, our study did not support an acute direct effect of TSH on OPG and RANK-L.
Giusti
Massimo
M
UO Clinica Endocrinologia, Istituto Scientifico San Raffaele, Milano, Italy. magius@unige.it
Cecoli
Francesca
F
Ghiara
Carla
C
Rubinacci
Alessandro
A
Villa
Isabella
I
Cavallero
Domenico
D
Mazzuoli
Laura
L
Mussap
Michele
M
Lanzi
Roberto
R
Minuto
Francesco
F
D000328:Adult; D000368:Aged; D000375:Aging; D002118:Calcium / Q000652:urine; D003404:Creatinine / Q000652:urine; D005260:Female; D006801:Humans; D006909:Hydroxyproline / Q000652:urine; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000503:physiopathology; D053244:Osteoprotegerin / Q000097:blood*; D017698:Postmenopause; D017697:Premenopause; D053245:RANK Ligand / Q000097:blood*; D011994:Recombinant Proteins / Q000008:administration & dosage; D013964:Thyroid Neoplasms / Q000097:blood* / Q000628:therapy; D013965:Thyroidectomy; D013972:Thyrotropin / Q000008:administration & dosage* / Q000097:blood; D013974:Thyroxine / Q000008:administration & dosage / Q000627:therapeutic use
D007457:Iodine Radioisotopes; D053244:Osteoprotegerin; D053245:RANK Ligand; D011994:Recombinant Proteins; D013972:Thyrotropin; D003404:Creatinine; D013974:Thyroxine; D006909:Hydroxyproline; D002118:Calcium