Abstract
To determine whether thyroid hormone (free thyroxine (fT4)) rather than TSH is directly related to bone mineral density (BMD).Design Cross-sectional population cohort study of peri-menopausal women.
Methods
Of a sample of 6846 peri-menopausal Dutch women who participated in an osteoporosis-screening programme, a cohort of 2584 was randomly selected for the assessment of thyroid function (TSH, fT4 and thyroid peroxidase antibodies (TPO-Abs)). TPO-Ab-positive women, with a previous history of thyroid dysfunction, overt thyroid disease, subclinical hypothyroidism, osteoporosis or bilateral oophorectomy and those receiving thyroid hormone or hormone replacement therapy were excluded. Of 1477 eligible women, 1426 had TSH and fT4 within the reference range and 51 had low or undetectable serum TSH. BMD was measured at the lumbar spine and low BMD was defined as <0.937 g/cm2.
Results
The mean BMD in the 51 women with low or undetectable serum TSH was 0.984 g/cm2 compared with 1.001 g/cm2 in the remaining 1426 (t=0.94, P=0.35); 33% of women with low or undetectable serum TSH had low BMD compared with 34% in 1426 euthyroid women. High fT4 but not low TSH in euthyroid women was related to low BMD by multiple logistic regression corrected for age, BMI and smoking (OR, 1.30; 95% CI, 1.02–1.69).
Conclusions
Higher fT4 levels within the normal reference range but not low or undetectable serum TSH were independently related to decreased BMD at lumbar spine in peri-menopausal women.
| Original language | English |
|---|---|
| Pages (from-to) | 461-468 |
| Journal | European Journal of Endocrinology |
| Volume | 170 |
| DOIs | |
| Publication status | Published - 2014 |
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Low bone mineral density is related to high physiological levels off T4 not to TSH levels below lower reference range. / van Rijn, L.E.; Pop, V.J.M.; Williams, G.
In: European Journal of Endocrinology, Vol. 170, 2014, p. 461-468.Research output: Contribution to journal › Article › Scientific › peer-review
TY - JOUR
T1 - Low bone mineral density is related to high physiological levels off T4 not to TSH levels below lower reference range.
AU - van Rijn, L.E.
AU - Pop, V.J.M.
AU - Williams, G.
PY - 2014
Y1 - 2014
N2 - Objective To determine whether thyroid hormone (free thyroxine (fT4)) rather than TSH is directly related to bone mineral density (BMD).Design Cross-sectional population cohort study of peri-menopausal women.Methods Of a sample of 6846 peri-menopausal Dutch women who participated in an osteoporosis-screening programme, a cohort of 2584 was randomly selected for the assessment of thyroid function (TSH, fT4 and thyroid peroxidase antibodies (TPO-Abs)). TPO-Ab-positive women, with a previous history of thyroid dysfunction, overt thyroid disease, subclinical hypothyroidism, osteoporosis or bilateral oophorectomy and those receiving thyroid hormone or hormone replacement therapy were excluded. Of 1477 eligible women, 1426 had TSH and fT4 within the reference range and 51 had low or undetectable serum TSH. BMD was measured at the lumbar spine and low BMD was defined as <0.937 g/cm2.Results The mean BMD in the 51 women with low or undetectable serum TSH was 0.984 g/cm2 compared with 1.001 g/cm2 in the remaining 1426 (t=0.94, P=0.35); 33% of women with low or undetectable serum TSH had low BMD compared with 34% in 1426 euthyroid women. High fT4 but not low TSH in euthyroid women was related to low BMD by multiple logistic regression corrected for age, BMI and smoking (OR, 1.30; 95% CI, 1.02–1.69).Conclusions Higher fT4 levels within the normal reference range but not low or undetectable serum TSH were independently related to decreased BMD at lumbar spine in peri-menopausal women.
AB - Objective To determine whether thyroid hormone (free thyroxine (fT4)) rather than TSH is directly related to bone mineral density (BMD).Design Cross-sectional population cohort study of peri-menopausal women.Methods Of a sample of 6846 peri-menopausal Dutch women who participated in an osteoporosis-screening programme, a cohort of 2584 was randomly selected for the assessment of thyroid function (TSH, fT4 and thyroid peroxidase antibodies (TPO-Abs)). TPO-Ab-positive women, with a previous history of thyroid dysfunction, overt thyroid disease, subclinical hypothyroidism, osteoporosis or bilateral oophorectomy and those receiving thyroid hormone or hormone replacement therapy were excluded. Of 1477 eligible women, 1426 had TSH and fT4 within the reference range and 51 had low or undetectable serum TSH. BMD was measured at the lumbar spine and low BMD was defined as <0.937 g/cm2.Results The mean BMD in the 51 women with low or undetectable serum TSH was 0.984 g/cm2 compared with 1.001 g/cm2 in the remaining 1426 (t=0.94, P=0.35); 33% of women with low or undetectable serum TSH had low BMD compared with 34% in 1426 euthyroid women. High fT4 but not low TSH in euthyroid women was related to low BMD by multiple logistic regression corrected for age, BMI and smoking (OR, 1.30; 95% CI, 1.02–1.69).Conclusions Higher fT4 levels within the normal reference range but not low or undetectable serum TSH were independently related to decreased BMD at lumbar spine in peri-menopausal women.
U2 - 10.1530/eje-13-0769
DO - 10.1530/eje-13-0769
M3 - Article
VL - 170
SP - 461
EP - 468
JO - European Journal of Endocrinology
JF - European Journal of Endocrinology
SN - 0804-4643
ER -