Endocrine Abstracts (2009) 20 P238

Evaluation of the association between bone turnover markers and OPG/sRANK-L levels in relation with the changes of thyroid function in women with thyroid cancer

Serpil Salman1, Ferihan Aral1, Harika Boztepe1, Nese Colak1, Beyhan Omer2, Refik Tanakol1, Faruk Alagol1 & Ayse Kabut-Uzum1


1Division of Endocrinology and Metabolism, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey; 2Central Laboratory of Biochemistry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.


Aim: Thyroid hormones play an important role in bone remodeling. The aim of the study was to evaluate the changes of bone markers and osteoprotegerin (OPG)/sRANK-L levels during follow-up in a group of patients with thyroid cancer.

Material and methods: Twenty euthyroid women with the diagnosis of differentiated thyroid cancer were enrolled to the study (39.25±13.46 years, 6 postmenopausal) before thyroidectomy. Samples were collected before the operation (euthyroid status) (EU), before radioactive iodine administration (hypothyroidism) (HYPO) and under thyroxine supressive therapy (subclinical hyperthyroidism) (SHYPER). In addition to OPG and sRANK-L, the markers of bone formation (BALP, osteocalcin and P1NP) and resorption (urinary DPD) were also evaluated. To determine the independent effect of bone formation markers and TSH on OPG, a multiple logistic regression model was used after pooling all the 3 visits’ data. Statistical analysis were performed on SPSS 15.0.

Results: The level of all bone formation markers except urinary DPD decreased in HYPO when compared to EU period (P=0.047 for BALP, P=0.003 for osteocalcin, P=0.024 for P1NP). However no significant change was observed in urinary DPD. In SHYPER period all of the bone formation markers increased and reached to the levels of EU period. OPG levels increased in HYPO period (P<0.001) and returned to comparable levels in SHYPER period. RANK-L levels did not change during the 3 different periods of the study. In multiple regression analysis, the only significant variable was TSH (r2=0.446, P=0.001).

Conclusion: In this study, we tried to investigate the relationship of thyroid dysfunction and skeletal system. The results indicate that there is a decrease in bone formation and an increase in OPG levels in HYPO but no change in SHYPER period. The increase in OPG level was related to increase in TSH but not to any of the bone formation markers.

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