Effects of TSH suppressive therapy on bone mineral density (BMD) and bone turnover markers (BTMs) in patients with differentiated thyroid cancer in Northeast China: a prospective controlled cohort study.

Abstract

This study aimed to evaluate the effects of thyroid-stimulating hormone (TSH) suppressive therapy on bone mineral density (BMD) and bone turnover markers (BTMs) in differentiated thyroid cancer (DTC) patients after postoperative 1-2 years in Northeast China. Five male, sixteen premenopausal, and eight postmenopausal female DTC patients receiving TSH suppressive therapy after thyroidectomy were enrolled. Patients were matched with healthy controls in a ratio of 1:2. All participants completed postoperative 1-year follow-up, and postmenopausal women completed 2-year follow-up. We measured BMD of the lumbar spine (LS), femoral neck (FN), and total hip (TH) using dual-energy X-ray absorptiometry (DXA). Bone formation marker P1NP and bone resorption marker β-CTX were also evaluated. Fracture risks were assessed by FRAX. There was no difference in BMD and BTMs between DTC patients and controls in the male group at 1-year follow-up. In the premenopausal women, the baseline P1NP was significantly lower in DTC patients than in the controls. The LS-BMD, FN-BMD, and TH-BMD in DTC patients were all higher than those in controls at 1-year follow-up. The difference in FN-BMD was not significant after adjusting for baseline P1NP. In the postmenopausal women, no differences in BMD and BTMs were observed between DTC patients and controls at the 1-year and 2-year follow-up. Our study indicated that postoperative 1-year TSH suppressive therapy did not show detrimental effects on BMD and BTMs in men, premenopausal, and postmenopausal DTC patients. The 2-year postoperative TSH suppressive therapy did not lead to additional loss of bone mass in postmenopausal DTC patients.