Bone mineral density in treated at a young age for differentiated thyroid cancer after Chernobyl female patients on TSH-suppressive therapy receiving or not Calcium-D3 supplementation.
Long-term management of patients with differentiated thyroid cancer (DTC) commonly includes TSH-suppressive therapy with L-T4 and, in case of postsurgical hypoparathyroidism, Calcium-D3 supplementation, both of which may affect skeletal health. Experience with female patients treated for DTC at a young age and who were then receiving long-term therapy with L-T4 and Calcium-D3 medication is very limited to date. This cross-sectional study set out to investigate effects of Calcium-D3 supplementation and TSH-suppressive therapy on bone mineral density (BMD) in 124 young female patients treated for DTC at a mean age of 14 years and followed-up for an average of 10 years. BMD was found to be significantly higher in patients receiving Calcium-D3 medication than in patients not taking supplements. The level of ionized calcium was the strongest factor determining lumbar spine BMD in patients not receiving Calcium-D3 supplementation. Pregnancy ending in childbirth and HDL-cholesterol were associated with a weak adverse effect on spine and femoral BMD. No evidence of adverse effects of L-T4 and of radioiodine therapies on BMD was found. We conclude that Calcium-D3 medication has a beneficial effect on BMD, and that TSH-suppressive therapy does not affect BMD in women treated for DTC at young age, at least after 10 years of follow-up.
Counseling-diagnostic Department of thyroid diseases, Minsk City Clinical Oncologic Dispensary, Minsk 220013, Belarus.
Tatiana A
TA
Leonova
Valentina M
VM
Drozd
Vladimir A
VA
Saenko
Mariko
M
Mine
Johannes
J
Biko
Tatiana I
TI
Rogounovitch
Noboru
N
Takamura
Christoph
C
Reiners
Shunichi
S
Yamashita
D000293:Adolescent; D015519:Bone Density / Q000187:drug effects / Q000528:radiation effects; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001862:Bone Resorption / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002136:Calcium, Dietary / Q000627:therapeutic use*; D047852:Chernobyl Nuclear Accident; D002762:Cholecalciferol / Q000627:therapeutic use*; D003131:Combined Modality Therapy / Q000009:adverse effects; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D006801:Humans; D007011:Hypoparathyroidism / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D015994:Incidence; D007457:Iodine Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology / Q000532:radiotherapy / Q000601:surgery; D011183:Postoperative Complications / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D019275:Radiopharmaceuticals / Q000009:adverse effects / Q000627:therapeutic use; D002094:Republic of Belarus / Q000453:epidemiology; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000532:radiotherapy / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects; D013974:Thyroxine / Q000009:adverse effects / Q000627:therapeutic use
D050071:Bone Density Conservation Agents; D002136:Calcium, Dietary; D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D002762:Cholecalciferol; D013974:Thyroxine