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Chung, Kang, Kim, Yoon, Lee, Choi, Park, and Kim: The Influence of Thyroid Function on Bone Mineral Density in Korean Postmenopausal Women
Original Article
The Journal of Korean Society of Menopause

The Journal of Korean Society of Menopause 2012; 18(1): 36-42.

Published online: 30 April 2012

DOI: https://doi.org/10.6118/jksm.2012.18.1.36

The Influence of Thyroid Function on Bone Mineral Density in Korean Postmenopausal Women

Hye Won Chung, M.D.1, Byung Moon Kang, M.D., Ph.D.2, 9, Mee Ran Kim, M.D., Ph.D.3, 9, Byung Koo Yoon, M.D., Ph.D.4, 9, Byung Seok Lee, M.D., Ph.D.5, 9, Hoon Choi, M.D., Ph.D.6, 9, Hyoung Moo Park, M.D., Ph.D.7, 9, Jung Gu Kim, M.D., Ph.D.8, 9

1Department of Obstetrics and Gynecology, College of Medicine, Ewha Woman's University, Seoul, Korea.

2Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Seoul, Korea.

3Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

4Department of Obstetrics and Gynecology, College of Medicine, Sungkyunkwan University, Seoul, Korea.

5Department of Obstetrics and Gynecology, College of Medicine, Yonsei University, Seoul, Korea.

6Department of Obstetrics and Gynecology, College of Medicine, Inje University, Seoul, Korea.

7Department of Obstetrics and Gynecology, College of Medicine, Chungang University, Seoul, Korea.

8Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, Korea.

9The Study Group of Menopause, Korea.

Address for Correspondence: Hye Won Chung, Department of Obstetrics and Gynecology, College of Medicine, Ewha Woman's University, 911-1 Mok-dong, Yangcheon-gu, Seoul 158-710, Korea. Tel: +82-2-2650-5568, Fax: +82-2-2647-9860, hyewon@ewha.ac.kr

Received 16 December 2011       Revised 2 January 2012       Accepted 2 January 2012

Copyright © 2012 by The Korean Society of Menopause

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/).

Abstract

Objectives

Osteoporosis, defined as decreased bone mass and structural deterioration of bone, increases the incidence of fractures. Recently, there have been reports suggesting that thyroid hormones are related to bone mineral density (BMD). It has been reported that low normal circulating thyrotropin (TSH) levels correlate with lower BMD and that thyroxine (T4) and bone density are negatively related. This research aims to examine the relationship between BMD and thyroid diseases and other functional changes in postmenopausal women.

Methods

The medical records of 2,279 postmenopausal women who attended the health care clinic in eight university hospitals between March 2001 and December 2007 were reviewed retrospectively. We determined the baseline characteristics of the women, including age, height, weight, and body mass index (BMI). The BMD was measured by dual-energy X-ray absorptiometry (DEXA). The correlation between the thyroid status and BMD was analyzed using the SPSS 12.0 program.

Results

This research used data from a relatively large number of postmenopausal women gathered in a multicenter approach. Of the thyroid functional tests, thyroid stimulating hormone (triiodothyronine or T3) and T4 correlated with BMD, while free T4 and TSH did not show a statistically significant correlation. After adjusted age, thyroid function test did not correlate with BMD. Osteopenia was significantly higher in the group with TSH below 0.5 mU/L compared with groups that had normal or high TSH. There was no statistically significant difference in lumbar BMD and total hip BMD among patients with thyroid diseases and healthy patients.

Conclusion

The level of T3 and T4 correlated well with BMD in Korean post-menopausal women.

Keywords: Bone mineral density, Menopause, Thyroid hormones

Figures and Tables

Fig. 1
Correlation graph between femur neck bone mineral density and serum thyroxine.
jksm-18-36-g001
Table 1
Thyroid hormone and bone mineral density of menopausal women
jksm-18-36-i001

Values are mean ± SD (standard deviation). TSH: thyroid stimulating hormone, BMD: bone mineral density, T3: triiodothyronine, T4: thyroxine, fT4: free thyroxine

Table 2
Bone mineral density according to thyroid disease
jksm-18-36-i002

Values are mean ± SD (standard deviation). BMD: Bone mineral density

Table 3
Status of bone density of menopausal women according to thyroid disease
jksm-18-36-i003
Table 4
Correlation between bone mineral density and serum thyroid function test
jksm-18-36-i004

CC: correlation coefficient, TSH: thyroid stimulating hormone, fT4: free thyroxine, T4: thyroxine, T3: triiodothyronine, BMD: bone mineral density

Table 5A
Status of bone density of menopausal women according to thyroid stimulating hormone status disease
jksm-18-36-i005

TSH: thyroid stimulating hormone

Table 5B
Bone mineral density according to thyroid stimulating hormone status
jksm-18-36-i006

Values are mean ± SD (standard deviation). TSH: thyroid stimulating hormone, BMD: bone mineral density

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