Rizik od preloma kostiju u osoba sa subkliničkim poremećajem funkcije štitaste žlezde
Fracture risk in subclinical thyroid dysfunction.
Author
Polovina, Snežana P.
Mentor
Popović-Brkić, VeraCommittee members
Trbojević, BožoŽarković, Miloš
Antić, Slobodan
Metadata
Show full item recordAbstract
Cilj studije preseka je bio da ispita povezanost između TSH i rizika od preloma kostiju
u populaciji pre i postmenopauzalnih žena sa subkliničkim hiper i hipotireoidizmom, sa
ciljem prepoznavanja osoba sa povećanim rizikom od osteoporotičnih fraktura.
METODOLOGIJA Računanje FRAX skora (10-godišnji pretpostavljeni rizik od
preloma kostiju) i merenje koštanih markera je primenjeno na 109 pre i
postmenopauzalnih žena sa novootkrivenim subkliničkim hiper ili hipotiroidizmom,
starosti 59.17±7.07 godina, prosečnog indeksa telesne mase 27.89 ±3.46kg/m2, sa
nastankom menopauze u 48.05±4.09 godini života i na 51 eutireoidnoj ženi, starosti
69±5.72, ITM 27.68 ± 4.66kg/m2, sa nastankom menopauze u 48.53±4.58 godini.
REZULTATI: Ukupni FRAX skor i FRAX za kuk je bio značajno veći u podgrupi sa
subkliničkim hipotireoidizmom (p<0.001 i p=0.001). U podgrupi sa subkliničkim
hipertireoidizmom je ukupni FRAX skor bio statistički značajno povećan (p=0.001).
Nije bilo povezanosti između niskog TSH i fraktu...rnog rizika. U podgrupi sa
subkliničkim hipotireoidizmom je nađena povezanost između TSH i osteokalcina
(p=0.02) i postojanja TPO antitela i ukupnog frakturnog rizika ( p=0.001).
ZAKLJUČAK: Pre i postmenopauzalne žene sa subkliničkom tireoidnom bolešću,
posebno autoimune prirode, imaju veći FRAX skore i time i veći rizik od preloma kuka
i drugih kostiju na malu trauma, u odnosu na pre i postmenopauzalne žene bez tireoidne
disfunkcije. Naši rezultati ukazuju na potrebu ispitivanja kvaliteta kostiju populacije
perimenopauzalnih žena sa subkliničkom tireoidnom bolešću u cilju sprečavanja
nastanka osteoporotičnih preloma kostiju.
OBJECTIVE: The aim of our cross-sectional study was to evaluate the relationship
between the TSH and fracture risk in pre and postmenopausal women with subclinical
hyper or hypothyroidism for evaluation of individuals with a high risk for osteoporotic
fractures.
DESIGN: FRAX score calculation (10-year estimated risk for bone fracture) and
measurement of bone markers were performed in 109 pre and postmenopausal women
with newly discovered subclinical hypothyroidism (mean age 59.17±7.07, mean BMI
27.89 ±3.46kg/m2, menopause onset in 48.05±4.09 years of age) and 51 matched
controls (mean age 59.69±5.72, mean BMI 27.68 ± 4.66kg/m2, menopause onset in
48.53±4.58 years of age) with normal thyroid function.
RESULTS: The main FRAX score and hip FRAX score were significantly higher in
the subgroup with subclinical hypothyroidism than in the controls (p<0.001 and
p=0.001). In subgroup with subclinical hyperthyroidism main FRAX score was
statisticaly significant (p=0.001). There was no correlatio...ns between low TSH and
fracture risk. There was significant correlations between osteocalcin and TSH (p=0.02)
in subgroup with subclinical hypothyroidism. Significant correlations was founded
between presence of TPOAb and main FRAX in subgroup with subclinical
hypothyroidism (p=0.001).
CONCLUSIONS: Perimenopausal women with subclinical thyroid dysfunctions, in
particular of autoimmune origin, have higher FRAX scores and a thus greater risk for
low-trauma hip and other site fractures than euthyroid postmenopausal women. Our
results point to the need of monitoring perimenopausal women with subclinical
hypothyroidism and hyperthyroidism for avoidance of fractures.