scholarly journals TSH suppressive therapy and bone

2020 ◽  
Vol 9 (7) ◽  
pp. R158-R172 ◽  
Author(s):  
Alessandro Brancatella ◽  
Claudio Marcocci
Keyword(s):  
Bone Loss ◽  
Postmenopausal Women ◽  
Bone Cells ◽  
Trabecular Bone Score ◽  
Experimental Studies ◽  
Bone Architecture ◽  
Tsh Receptor ◽  
Suppressive Therapy ◽  
Mineral Density ◽  
Increased Risk

Thyroid hormones stimulate bone turnover in adults by increasing osteoclastic bone resorption. TSH suppressive therapy is usually applied in patients with differentiated thyroid cancer (DTC) to improve the disease outcome. Over the last decades several authors have closely monitored the potential harm suffered by the skeletal system. Several studies and meta-analyses have shown that chronic TSH suppressive therapy is safe in premenopausal women and men. Conversely, in postmenopausal women TSH suppressive therapy is associated with a decrease of bone mineral density, deterioration of bone architecture (quantitative CT, QCT; trabecular bone score, TBS), and, possibly, an increased risk of fractures. The TSH receptor is expressed in bone cells and the results of experimental studies in TSH receptor knockout mice and humans on whether low TSH levels, as opposed to solely high thyroid hormone levels, might contribute to bone loss in endogenous or exogenous thyrotoxicosis remain controversial. Recent guidelines on the use of TSH suppressive therapy in patients with DTC give value not only to its benefit on the outcome of the disease, but also to the risks associated with exogenous thyrotoxicosis, namely menopause, osteopenia or osteoporosis, age >60 years, and history of atrial fibrillation. Bone health (BMD and/or preferably TBS) should be evaluated in postmenopausal women under chronic TSH suppressive therapy or in those patients planning to be treated for several years. Antiresorptive therapy could also be considered in selected cases (increased risk of fracture or significant decline of BMD/TBS during therapy) to prevent bone loss.

scholarly journals The Ovariectomized Rat as a Model for Studying Alveolar Bone Loss in Postmenopausal Women

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Bryan D. Johnston ◽  
Wendy E. Ward
Keyword(s):  
Chronic Disease ◽  
Bone Loss ◽  
Postmenopausal Women ◽  
Alveolar Bone ◽  
Measurement Techniques ◽  
Postmenopausal Bone Loss ◽  
Ovariectomized Rat ◽  
Mineral Density ◽  
Increased Risk ◽  
Tooth Retention

In postmenopausal women, reduced bone mineral density at the hip and spine is associated with an increased risk of tooth loss, possibly due to a loss of alveolar bone. In turn, having fewer natural teeth may lead to compromised food choices resulting in a poor diet that can contribute to chronic disease risk. The tight link between alveolar bone preservation, tooth retention, better nutritional status, and reduced risk of developing a chronic disease begins with the mitigation of postmenopausal bone loss. The ovariectomized rat, a widely used preclinical model for studying postmenopausal bone loss that mimics deterioration of bone tissue in the hip and spine, can also be used to study mineral and structural changes in alveolar bone to develop drug and/or dietary strategies aimed at tooth retention. This review discusses key findings from studies investigating mandible health and alveolar bone in the ovariectomized rat model. Considerations to maximize the benefits of this model are also included. These include the measurement techniques used, the age at ovariectomy, the duration that a rat is studied after ovariectomy and habitual diet consumed.

scholarly journals Trabecular Bone Score and Bone Mineral Density in Postmenopausal Women with Morbid Obesity—A Clinical Paradox

2021 ◽  
Vol 9 (4) ◽  
pp. 69
Author(s):  
Antresa Jose ◽  
Kripa Elizabeth Cherian ◽  
Munaf Babajan Nandyal ◽  
Stephen A. Jiwanmall ◽  
Dheeraj Kattula ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Morbid Obesity ◽  
Trabecular Bone ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Bone Architecture ◽  
P Value ◽  
Mineral Density

Obesity has long been considered to have a protective effect on bone, but specific complications in those with morbid obesity are known to have a detrimental impact on bone architecture. We aimed to study the bone microarchitecture (TBS—trabecular bone score) and bone mineral density (BMD) in postmenopausal women with morbid obesity compared to obese and non-obese age-matched women. Eighty-five consecutive postmenopausal women with morbid obesity (body mass index (BMI) ≥ 35 kg/m2) were enrolled and compared to age-matched obese (n = 80) and non-obese postmenopausal controls (n = 85). The BMD and TBS were assessed in all subjects using a Hologic-QDR 4500-W Discovery-A DXA scanner. The mean BMD (gm/cm2) at the femoral neck in women with morbid obesity was found to be significantly lower as compared to the age-matched postmenopausal obese controls (0.723 versus 0.762, p-value = 0.002). The BMD at the lumbar spine and hip showed similar trends but were not statistically significant. The bone microarchitecture was found to be significantly lower in those with morbid obesity (1.205) as compared to the other two groups (obesity 1.244; non-obese 1.228) (p < 0.013). Though obesity was associated with a better bone density and bone microarchitecture in postmenopausal women, a paradoxical lower value was seen in those with morbid obesity.

scholarly journals Trabecular Bone Score in Women With Differentiated Thyroid Cancer

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A872-A872
Author(s):  
Barbara Erika Caldeira Araujo Sousa ◽  
Maria Marta Sarquis Soares ◽  
Barbara Campolina Silva ◽  
Adriana Maria Kakehasi ◽  
Magda Carvalho Pires
Keyword(s):  
Thyroid Cancer ◽  
Trabecular Bone ◽  
Postmenopausal Women ◽  
Differentiated Thyroid Cancer ◽  
Trabecular Bone Score ◽  
Menopausal Status ◽  
Premenopausal Women ◽  
Suppressive Therapy ◽  
Mineral Density ◽  
Normal Range

Abstract Introduction: Thyrotropin stimulating hormone (TSH) suppression in patients with differentiated thyroid cancer (DTC) aims to decrease the growth and proliferation of thyroid cancer cells. However, the effect of TSH suppressive therapy on bone microarchitecture remains undefined. Methods: Cross-sectional study including 43 women with DTC undergoing TSH suppressive therapy (sTSH) compared to 20 women also on levothyroxine therapy but with TSH in the low-normal range (nTSH) since the thyroid surgery. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA), and trabecular bone score (TBS) was evaluated using the TBS iNsigth software. The relationship between suppressive therapy-related parameters and bone parameters was investigated. Results: The TBS mean values were not significantly different in the sTSH and nTSH groups (1.273 ± 0.12 vs 1.307 ± 0.14, p = 0.7197). In both groups, postmenopausal women had degraded microarchitecture (TBS 1.216 ± 0.11 vs 1.213 ± 0.09, p = 0.9333), while premenopausal women had normal microarchitecture (1.328 ± 0.11 vs 1.401 ± 0.12, p = 0.195). The percentage of all postmenopausal women with degraded TBS was 54.7%, while the percentage of osteoporosis diagnoses was 16.1%. Body mass index (BMI) and menopausal status were the only variables associated with TBS and BMD. Conclusion: Long-term TSH suppressive therapy does not seem to be associated with deterioration of the trabecular microarchitecture in premenopausal women. However, lower TBS values were observed in postmenopausal women of both groups, even in those with nonsuppressive therapy. These data show that treatment with thyroid hormone in DTC can be detrimental to bone quality in postmenopausal women, regardless of whether TSH levels are maintained chronically suppressed or in the low-normal range.

scholarly journals The Ability of Exercise to Mitigate Caloric Restriction-Induced Bone Loss in Older Adults: A Structured Review of RCTs and Narrative Review of Exercise-Induced Changes in Bone Biomarkers

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1250
Author(s):  
Sarah J. Wherry ◽  
Ryan M. Miller ◽  
Sarah H. Jeong ◽  
Kristen M. Beavers
Keyword(s):  
Older Adults ◽  
Bone Loss ◽  
Caloric Restriction ◽  
Controlled Trial ◽  
Areal Bone Mineral Density ◽  
Bone Biomarkers ◽  
Mineral Density ◽  
Increased Risk ◽  
Exercise Induced ◽  
Induced Changes

Despite the adverse metabolic and functional consequences of obesity, caloric restriction- (CR) induced weight loss is often contra-indicated in older adults with obesity due to the accompanying loss of areal bone mineral density (aBMD) and subsequent increased risk of fracture. Several studies show a positive effect of exercise on aBMD among weight-stable older adults; however, data on the ability of exercise to mitigate bone loss secondary to CR are surprisingly equivocal. The purpose of this review is to provide a focused update of the randomized controlled trial literature assessing the efficacy of exercise as a countermeasure to CR-induced bone loss among older adults. Secondarily, we present data demonstrating the occurrence of exercise-induced changes in bone biomarkers, offering insight into why exercise is not more effective than observed in mitigating CR-induced bone loss.

scholarly journals Common variants in MAEA gene contributed the susceptibility to osteoporosis in Han Chinese postmenopausal women

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xuan Cai ◽  
Jun Dong ◽  
Teng Lu ◽  
Liqiang Zhi ◽  
Xijing He
Keyword(s):  
Postmenopausal Women ◽  
Chinese Women ◽  
Han Chinese ◽  
Blood Levels ◽  
Nucleotide Polymorphisms ◽  
Mineral Density ◽  
Association Analyses ◽  
Metabolism Disorder ◽  
Increased Risk ◽  
Chinese Postmenopausal Women

Abstract Background Osteoporosis (OP) is a complex bone metabolism disorder characterized by the loss of bone minerals and an increased risk of bone fracture. A recent study reported the relationship of the macrophage erythroblast attacher gene (MAEA) with low bone mineral density in postmenopausal Japanese women. Our study aimed to investigate the association of MAEA with postmenopausal osteoporosis (PMOP) in Han Chinese individuals. Methods A total of 968 unrelated postmenopausal Chinese women comprising 484 patients with PMOP and 484 controls were recruited. Four tag single nucleotide polymorphisms (SNPs) that covered the gene region of MAEA were chosen for genotyping. Single SNP and haplotypic association analyses were performed, and analysis of variance was conducted to test the correlation between blood MAEA protein level and genotypes of associated SNPs. Results SNP rs6815464 was significantly associated with the risk of PMOP. The C allele of rs6815464 was strongly correlated with the decreased risk of PMOP in our study subjects (OR[95% CI]=0.75[0.63-0.89], P=0.0015). Significant differences in MAEA protein blood levels among genotypes of SNP rs6815464 were identified in both the PMOP (F=6.82, P=0.0012) and control groups (F=11.5, P=0.00001). The C allele was positively associated with decreased MAEA protein levels in blood. Conclusion This case-control study on Chinese postmenopausal women suggested an association between SNP rs6815464 of MAEA and PMOP. Further analyses showed that genotypes of SNP rs6815464 were also associated with the blood level of MAEA protein.

scholarly journals DXA parameters, Trabecular Bone Score (TBS) and Bone Mineral Density (BMD), in fracture risk prediction in endocrine-mediated secondary osteoporosis

Endocrine ◽  
2021 ◽  
Author(s):  
Enisa Shevroja ◽  
Francesco Pio Cafarelli ◽  
Giuseppe Guglielmi ◽  
Didier Hans
Keyword(s):  
Bone Mineral Density ◽  
Trabecular Bone ◽  
Bone Mineral ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Fragility Fractures ◽  
Endocrine Disorders ◽  
Mineral Density ◽  
Increased Risk

AbstractOsteoporosis, a disease characterized by low bone mass and alterations of bone microarchitecture, leading to an increased risk for fragility fractures and, eventually, to fracture; is associated with an excess of mortality, a decrease in quality of life, and co-morbidities. Bone mineral density (BMD), measured by dual X-ray absorptiometry (DXA), has been the gold standard for the diagnosis of osteoporosis. Trabecular bone score (TBS), a textural analysis of the lumbar spine DXA images, is an index of bone microarchitecture. TBS has been robustly shown to predict fractures independently of BMD. In this review, while reporting also results on BMD, we mainly focus on the TBS role in the assessment of bone health in endocrine disorders known to be reflected in bone.

Circulating Biomarkers Related to Osteocyte and Calcium Homeostasis between Postmenopausal Women with and without Osteoporosis

2021 ◽  
Vol 21 ◽  
Author(s):  
Chin Yi Chan ◽  
Shaanthana Subramaniam ◽  
Norazlina Mohamed ◽  
Norliza Muhammad ◽  
Fitri Fareez Ramli ◽  
...  
Keyword(s):  
Bone Turnover ◽  
Postmenopausal Women ◽  
Calcium Homeostasis ◽  
Bone Cells ◽  
Control Group ◽  
Protein Markers ◽  
Mineral Density ◽  
Hydroxyvitamin D ◽  
Hip Bmd ◽  
Turnover Markers

Background: The currently available bone turnover markers are mostly derived from osteoblasts or osteoclasts. Protein markers derived from osteocytes, the most abundant bone cells that can regulate bone turnover activities by other cells, are less explored. Objective: This study aimed to compare the circulating markers of osteocytes and calcium homeostasis between Malaysian postmenopausal women with and without osteoporosis. Method: Postmenopausal women with (n=20) or without osteoporosis (n=20) as determined by dual-energy X-ray absorptiometry were randomly drawn from a bone health cohort. Their fasting blood was collected and assayed by a multiplex immunoassay panel. Results: The results showed that osteoprotegerin and sclerostin levels were significantly lower among postmenopausal women with osteoporosis than the normal control. No significant differences in other markers were observed between the two groups. Sclerostin level correlated positively with spine bone mineral density (BMD), while 25-hydroxyvitamin D correlated negatively with hip BMD in the control group. No significant correlation was observed between other markers with spine or hip BMD. Conclusion: These data provide an insight into the possible roles of osteocyte markers, especially osteoprotegerin and sclerostin in classifying subjects with osteoporosis. However, the lack of association between these markers and BMD indicates that osteoporosis is a complex and multifactorial condition.

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