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Endocrine Abstracts (2014) 35 P960 | DOI: 10.1530/endoabs.35.P960

1Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Clinical Center os Serbia, Belgrade, Serbia; 2Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Serbia, Belgrade, Serbia; 3Emergency Center, Clinical Center of Serbia, Belgrade, Serbia, Belgrade, Serbia.


Introduction: FRAX score is the ten-year estimated risk calculation tool for bone fracture which includes clinical data and hip bone mineral density measured by x-ray densitometry (DXA). The aim of the study was to elucidate the ability of the FRAX score in discriminating between bone fracture positive and negative postmenopausal women with subclinical hyperthyroidism.

Material and methods: FRAX score calculation were performed in 27 postmenopausal women with newly discovered subclinical hyperthyroidism (58.85±7.83 age, BMI 27.89±3.46 kg/m2, menopause onset in 46.88±10.21 years) and 51 matched euthyroid controls (59.69±5.72 age, BMI 27.68±4.66 kg/m2, menopause onset in 48.53±4.58 years).

Results: In group with subclinical hyperthyroidism main FRAX score was statistically significant higher (6.50±1.58 vs 4.35±1.56, P=0.015). FRAX for hip was also higher in evaluated group than in control (1.33±3.92 vs 0.50±0.46, P=0.022). There was no correlations between low TSH and fracture risk (P>0.05). The ability of the FRAX score in discriminating between bone fracture positive and negative postmenopausal female subjects (P<0.001) is presented by area under the curve (AUC) plotted via ROC analysis. The determined FRAX score cut-off value by this analysis is 6%, with estimated sensitivity and specificity of 95 and 75.9%, respectively (Table 1).

Table 1 ROC analysis for TSH and FRAX score in group with subclinical hyperthyroidism.
AreaSEP95% CI for SE
TSH0.6440.1620.3360.326–0.961
Main FRAX 0.9980.0030.0010.992–1.005
Hip FRAX 0.7500.1920.0940.373–1.127

Conclusion: Postmenopausal women with subclinical hyperthyroidism have higher FRAX scores and a thus greater risk for low-trauma hip fracture than euthyroid postmenopausal women. Our results point to the need of monitoring peri-menopausal women with subclinical hyperthyroidism for avoidance of fractures.

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