Endocrine Abstracts (2007) 14 P409

Bone mineral density and bone markers in patients on long-term suppressive levothyroxine therapy for differentiated thyroid carcinoma

F. Mouton1, M. D’Herbomez2, C. Do Cao1, F. Tison-Muchery2, X. Marchandise2 & J.-L. Wemeau1

1Clinique d’Enocrinologie Marc Linquette, CHRU Lille, Lille, France; 2Service de Médecine Nuclaire, Hopital Roger Salengro, CHRU Lille, Lille, France.

Methods: In a prospective longitudinal study, 156 determinations of osteocalcine (OC) as a marker of bone formation, and of C-telopeptide of type-1 collagene (CTX and ICTP) as markers of bone resorption were performed in 103 patients {20 men (median age 50 years), 83 females (median age 56 years – 58% with age >50 years)} treated with suppressive levothyroxine therapy for DTC. Bone mineral density (BMD) of the hip was measured by dual X-ray absorptiometry (DXA) and lateral DXA pictures of the lumbar and thoracic vertebrae were performed (n=16 for 13 patients). The mean of follow-up was 9 years (range 0.5–36 years).

Results: All OC results, except three, were in the normal range. Thirsty one ICTP and 36 CTX levels were increased (together 13% of the evaluations). A positive significant correlation was found between the ICTP concentrations and the duration of the follow up (n=146, r=0.15, 0.02<P<0.05). BMD and resorption markers were concordant for 69% of the evaluations (7 with both normal, 4 with increased resorption markers and decreased BMD). For the discordant results, BMD were low in ostepenia for 4 patients with resorption markers in normal range, one isolated high ICTP concentration has been found.

Conclusion: 1) Only the resorption markers are increased in patients on long term LT4 therapy for DTC 2) prevalence of high CTX and ITP is the same for men and females >50 years (26%), lower (18%) for women <50 years 3) bone resorption markers could be used for screening patients at risk of osteopenia, when treated with suppressive levothyroxine therapy for DTC.

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