title: Thyroid function and autoimmunity are associated with the risk of vertebral fractures in postmenopausal women.
abstract: Overt or subclinical thyroid dysfunction may affect the risk of fragility fractures. The aim of the present study was to assess the association of thyroid function and autoimmunity with vertebral fractures (VF) in a large sample of Greek postmenopausal women. This cross-sectional study recruited 335 euthyroid postmenopausal women, aged 35-79 years. Euthyroidism was verified by serum thyroid-stimulating hormone (TSH) within the laboratory reference range (0.4-4.5 μIU/mL). VFs were diagnosed by lumbar spine lateral radiographs, according to quantitative procedures. Serum free triiodothyronine (FT3), free thyroxine (FT4), TSH, as well as levels of anti-thyroglobulin (anti-TG) and thyroid peroxidase antibodies (anti-TPO) were compared according to the presence of VFs. Multivariate logistic regression showed that the presence of VFs was predicted independently by ln-TSH levels (OR = 0.290, p = 0.037) and positive anti-TG antibodies (OR = 3.308, p = 0.026) in models adjusted for age, menopausal age, and ln-HOMA-IR. Stepwise logistic regression analysis showed that the presence of VFs was predicted by menopausal age (OR = 1.120, p = 0.001), ln-TSH (OR = 0.312, p = 0.052), and thyroid autoimmunity (anti-TG and anti-TPO positive: OR = 6.637, p = 0.007) in a model that also included age and ln-HOMA-IR. Women with lower circulating TSH had higher risk of having a VF, independently of age, menopausal age, and insulin resistance. The presence of positive anti-TG/anti-TPO antibodies also indicated an elevated risk of fracture. Levels of thyroid hormones had no apparent effect on the risk of fracture. Further studies are necessary to establish the significance of our findings.
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 27, Themistokleous Street, Dionysos, 14578, Athens, Greece. ilambrinoudaki@aretaieio.uoa.gr.
authors.forename: Irene
authors.initials: I
authors.lastname: Lambrinoudaki
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 27, Themistokleous Street, Dionysos, 14578, Athens, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Armeni
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 27, Themistokleous Street, Dionysos, 14578, Athens, Greece.
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Pliatsika
authors.affiliation: Hormonal and Biochemical Laboratory, University of Athens, Aretaieio Hospital, Athens, Greece.
authors.forename: Demetrios
authors.initials: D
authors.lastname: Rizos
authors.affiliation: Hormonal and Biochemical Laboratory, University of Athens, Aretaieio Hospital, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Kaparos
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 27, Themistokleous Street, Dionysos, 14578, Athens, Greece.
authors.forename: Areti
authors.initials: A
authors.lastname: Augoulea
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 27, Themistokleous Street, Dionysos, 14578, Athens, Greece.
authors.forename: Andreas
authors.initials: A
authors.lastname: Alexandrou
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 27, Themistokleous Street, Dionysos, 14578, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Flokatoula
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 27, Themistokleous Street, Dionysos, 14578, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Creatsa
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 27, Themistokleous Street, Dionysos, 14578, Athens, Greece.
authors.forename: Constantinos
authors.initials: C
authors.lastname: Panoulis
authors.affiliation: 1st Department of Neurology, University of Athens, Aiginiteio Hospital, Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Triantafyllou
authors.affiliation: 1st Department of Radiology, University of Athens, Aretaieio Hospital, Athens, Greece.
authors.forename: Xenofon
authors.initials: X
authors.lastname: Papacharalambous
mesh_terms: D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood; D015551:Autoimmunity; D003430:Cross-Sectional Studies; D005260:Female; D006115:Greece; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology*; D008875:Middle Aged; D017698:Postmenopause; D012307:Risk Factors; D016103:Spinal Fractures / Q000453:epidemiology*; D013961:Thyroid Gland / Q000503:physiopathology*; D013972:Thyrotropin / Q000097:blood*; D014284:Triiodothyronine / Q000097:blood
chemical_list: D001323:Autoantibodies; C006606:anti-thyroglobulin; C056626:thyroid microsomal antibodies; D014284:Triiodothyronine; D013972:Thyrotropin
keywords: Insulin; Postmenopausal women; Thyroid stimulating hormone; Vertebral fractures