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Study of Correlation between Serum Osteoprotegerin, TNF-Alfa, and Biomarkers of Bone Metabolism in Patients with Treatment-Naive Graves’ Disease—A Cross-Sectional Study

OBJECTIVES: Primary – a study of the correlation between serum osteoprotegerin (OPG), and biomarkers of bone metabolism in patients with treatment-naive Graves’ disease (GD). Secondary – serum level of OPG, TNF-alfa, and biomarkers of bone metabolism in patients three months after treatment of GD wi...

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Autores principales: Behera, Kishore, Sahu, Suchanda, Agrawal, Kanhaiyalal, Soren, Uttam K., Parida, Girish K., Srinivasan, Anand
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10198200/
https://www.ncbi.nlm.nih.gov/pubmed/37215268
http://dx.doi.org/10.4103/ijem.ijem_207_22
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author Behera, Kishore
Sahu, Suchanda
Agrawal, Kanhaiyalal
Soren, Uttam K.
Parida, Girish K.
Srinivasan, Anand
author_facet Behera, Kishore
Sahu, Suchanda
Agrawal, Kanhaiyalal
Soren, Uttam K.
Parida, Girish K.
Srinivasan, Anand
author_sort Behera, Kishore
collection PubMed
description OBJECTIVES: Primary – a study of the correlation between serum osteoprotegerin (OPG), and biomarkers of bone metabolism in patients with treatment-naive Graves’ disease (GD). Secondary – serum level of OPG, TNF-alfa, and biomarkers of bone metabolism in patients three months after treatment of GD with methimazole (MMI). MATERIALS AND METHODS: A total of thirty-five treatment-naive newly diagnosed GDs were recruited for the study, most of them female. All patients started with MMI for treatment and various blood parameters were measured at baseline and three months after treatment. Measurements: Serum calcium (Ca), phosphorus (P), bone-specific alkaline phosphatase (B-ALP), OPG, TNF-alfa, and urine deoxypyridinoline (U-DPD) along with serum-free T3 and T4, thyroid-stimulating hormone (TSH) and thyroid receptor antibody (TR-ab) were analysed at baseline and three months after MMI treatment. All the patients had euthyroid at three months of MMI treatment. RESULTS: Mean serum OPG (0.94 ± 1.39 vs. 0.63 ± 0.27 ng/ml; P = 0.262) level at baseline and after treatment with MMI did not show any significant change. Mean TSH level (0.207 ± 0.59 vs. 1.00 ± 1.95, P = 0.025) was significantly low at baseline than after treatment; FT4 (5.9 ± 5.22 v 1.77 ± 1.89 ng/dl; P < 0.001), FT3 (12.19 ± 6.91 vs. 4.99 ± 3.55 pg/ml; P < 0.001), and TNF-alfa values decreased significantly after treatment, however, PTH (58.09 ± 28.75 vs. 75.57 ± 41.50; P < 0.026) increased significantly after treatment. DISCUSSION: There is no correlation of OPG with thyroid hormone profile, TSH, thyroid receptor antibody (TR-ab), and bone metabolic parameters such as serum Ca, P, B-ALP, TNF-alfa, and U-DPD in our study. Mean TNF-alfa decreased significantly (393.43 ± 270.473 vs. 139.34 ± 101.264 pg/ml; P = 0.001) level after treatment with MMI. TNF-alfa was positively correlated with TR-ab (r = 0.374; P = 0.027) and B-ALP (r = 0.388; P = 0.021). CONCLUSION: The bone turnover marker in GD seems to be mediated other than OPG. We observed an increase in circulating TNF-alfa in GD with a significant decrease after treatment. TNF-alfa could be a marker of GD activity as evidenced by a close positive correlation with TR-ab, a sensitive marker of GD autoimmunity. TNF-alfa could be a factor associated with bone turnover markers in GD despite its euthyroid state.
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spelling pubmed-101982002023-05-20 Study of Correlation between Serum Osteoprotegerin, TNF-Alfa, and Biomarkers of Bone Metabolism in Patients with Treatment-Naive Graves’ Disease—A Cross-Sectional Study Behera, Kishore Sahu, Suchanda Agrawal, Kanhaiyalal Soren, Uttam K. Parida, Girish K. Srinivasan, Anand Indian J Endocrinol Metab Original Article OBJECTIVES: Primary – a study of the correlation between serum osteoprotegerin (OPG), and biomarkers of bone metabolism in patients with treatment-naive Graves’ disease (GD). Secondary – serum level of OPG, TNF-alfa, and biomarkers of bone metabolism in patients three months after treatment of GD with methimazole (MMI). MATERIALS AND METHODS: A total of thirty-five treatment-naive newly diagnosed GDs were recruited for the study, most of them female. All patients started with MMI for treatment and various blood parameters were measured at baseline and three months after treatment. Measurements: Serum calcium (Ca), phosphorus (P), bone-specific alkaline phosphatase (B-ALP), OPG, TNF-alfa, and urine deoxypyridinoline (U-DPD) along with serum-free T3 and T4, thyroid-stimulating hormone (TSH) and thyroid receptor antibody (TR-ab) were analysed at baseline and three months after MMI treatment. All the patients had euthyroid at three months of MMI treatment. RESULTS: Mean serum OPG (0.94 ± 1.39 vs. 0.63 ± 0.27 ng/ml; P = 0.262) level at baseline and after treatment with MMI did not show any significant change. Mean TSH level (0.207 ± 0.59 vs. 1.00 ± 1.95, P = 0.025) was significantly low at baseline than after treatment; FT4 (5.9 ± 5.22 v 1.77 ± 1.89 ng/dl; P < 0.001), FT3 (12.19 ± 6.91 vs. 4.99 ± 3.55 pg/ml; P < 0.001), and TNF-alfa values decreased significantly after treatment, however, PTH (58.09 ± 28.75 vs. 75.57 ± 41.50; P < 0.026) increased significantly after treatment. DISCUSSION: There is no correlation of OPG with thyroid hormone profile, TSH, thyroid receptor antibody (TR-ab), and bone metabolic parameters such as serum Ca, P, B-ALP, TNF-alfa, and U-DPD in our study. Mean TNF-alfa decreased significantly (393.43 ± 270.473 vs. 139.34 ± 101.264 pg/ml; P = 0.001) level after treatment with MMI. TNF-alfa was positively correlated with TR-ab (r = 0.374; P = 0.027) and B-ALP (r = 0.388; P = 0.021). CONCLUSION: The bone turnover marker in GD seems to be mediated other than OPG. We observed an increase in circulating TNF-alfa in GD with a significant decrease after treatment. TNF-alfa could be a marker of GD activity as evidenced by a close positive correlation with TR-ab, a sensitive marker of GD autoimmunity. TNF-alfa could be a factor associated with bone turnover markers in GD despite its euthyroid state. Wolters Kluwer - Medknow 2023 2023-03-03 /pmc/articles/PMC10198200/ /pubmed/37215268 http://dx.doi.org/10.4103/ijem.ijem_207_22 Text en Copyright: © 2023 Indian Journal of Endocrinology and Metabolism https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Behera, Kishore
Sahu, Suchanda
Agrawal, Kanhaiyalal
Soren, Uttam K.
Parida, Girish K.
Srinivasan, Anand
Study of Correlation between Serum Osteoprotegerin, TNF-Alfa, and Biomarkers of Bone Metabolism in Patients with Treatment-Naive Graves’ Disease—A Cross-Sectional Study
title Study of Correlation between Serum Osteoprotegerin, TNF-Alfa, and Biomarkers of Bone Metabolism in Patients with Treatment-Naive Graves’ Disease—A Cross-Sectional Study
title_full Study of Correlation between Serum Osteoprotegerin, TNF-Alfa, and Biomarkers of Bone Metabolism in Patients with Treatment-Naive Graves’ Disease—A Cross-Sectional Study
title_fullStr Study of Correlation between Serum Osteoprotegerin, TNF-Alfa, and Biomarkers of Bone Metabolism in Patients with Treatment-Naive Graves’ Disease—A Cross-Sectional Study
title_full_unstemmed Study of Correlation between Serum Osteoprotegerin, TNF-Alfa, and Biomarkers of Bone Metabolism in Patients with Treatment-Naive Graves’ Disease—A Cross-Sectional Study
title_short Study of Correlation between Serum Osteoprotegerin, TNF-Alfa, and Biomarkers of Bone Metabolism in Patients with Treatment-Naive Graves’ Disease—A Cross-Sectional Study
title_sort study of correlation between serum osteoprotegerin, tnf-alfa, and biomarkers of bone metabolism in patients with treatment-naive graves’ disease—a cross-sectional study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10198200/
https://www.ncbi.nlm.nih.gov/pubmed/37215268
http://dx.doi.org/10.4103/ijem.ijem_207_22
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