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SAT-LB090 Osteoporosis in Menopausal Women with Autoimmune Thyroiditis

Introduction. Autoimmune thyroiditis may be an important factor that can affect bone quality. There seems to be a connection between systemic inflammation and impaired bone density. Disturbance in osteclastic activity in new bone formation might be a consequence of chronic inflammatory autoimmune di...

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Detalles Bibliográficos
Autores principales: Preda, Cristina, Leustean, Letitia, Ungureanu, Maria, Teodoriu, Laura, Branisteanu, Dumitru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Endocrine Society 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6551762/
http://dx.doi.org/10.1210/js.2019-SAT-LB090
Descripción
Sumario:Introduction. Autoimmune thyroiditis may be an important factor that can affect bone quality. There seems to be a connection between systemic inflammation and impaired bone density. Disturbance in osteclastic activity in new bone formation might be a consequence of chronic inflammatory autoimmune disorders leading to osteopenia or osteoporosis. Aim. To estimate the prevalence of osteoporosis in menopausal women with autoimmune thyroiditis. Patients and method. Cross-sectional study of a tertiary endocrine center. 207 menopausal women diagnosed with autoimmune thyroiditis underwent a bone density scan: dual-energy x-ray absorptiometry (DEXA) along with phospho-calcic (Ca, P, PTH, vit D) and thyroid (TSH, TPO-Ab) profile. Results. The mean age of the patients was 63.24±9.33. According with medical history and treatment 91 (43.9%) patients presented hypothyroidism, 14 (6.8%) hyperthyroidism and 102 (49.3%) without known thyroid dysfunction at the moment of screening. After the DEXA scan 77 patients (37.1%) had a T-score< -2.5 SD, 120 (58%) T-score between -2.5 and -1 SD, and 10 patients (4.9%) a T-score> -1SD. In the group with osteoporotic women 32 (41.5%) had treatment with levothyroxine, 4 (5.2%) had treatment with methimazole and 41 (53.3%) no treatment. In the group with osteopenia 55 women (45.9%) had treatment with levothyroxine, 56 (46.6%) no treatment and 9 patients (7.5%) had treatment with methimazole. In the group with normal BMD 5 patients (50%) had no treatment, 4 (40%) had treatment with levothyroxine and only 1 (10%) was in treatment with methymazole. 193 patients (93.2%) presented normal thyroid function (TSH 0.27-4.20µUI/ml) and only 14 women with autoimmune thyroiditis presented abnormal TSH (6 with TSH> 10 and 8 TSH< 0.27 µUI/ml). All the 6 patients with high TSH were treated with levothyroxin and required an increase in levothyroxine dosage. Of the 8 patients with decreased TSH: 4 were treated with levothyroxin, 3 with methimazole and 1 with no treatment. All these patients required a change in dosage according with TSH values and clinical examination. Conclusions. In our study the prevalence of osteoporosis was 37.1%. The presence of autoimmune thyroiditis was associated with an increased risk of low bone density regardless the thyroid function. In a fairly equal number of cases 41.5% with substitutive treatment (for hypothyroidism) vs. 53.3% untreated (euthyroidism) the diagnosis of osteoporosis was made. From the clinical point of view our results shows the importance of screening for osteoporosis in menopausal women with autoimmune thyroiditis Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. Abstracts presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.