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The Effect of Hyperthyroidism on Bone Mineral Density in Premenopausal Women

Zeynep Zengin and Ayse Cikim Sertkaya

Background: The effects of subclinical hyperthyroidism and clinical hyperthyroidism on bone metabolism in premenopausal women are contradictory.

Methods: Sixteen hyperthyroid (31.3±9.5 yrs), 23 subclinical hyperthyroid (33.7±7.3 yrs) and 20 healthy (31.7±8.1 yrs) premenopausal women were evaluated. Bone mineral density (BMD) was assessed by dual energy X-ray absorptiometry (DXA). Osteocalcin, total alkaline phosphatase (tALP), homocysteine, β-2 microglobulin, hsCRP and deoxypyridinoline (DPD) concentrations were assessed. Demographic and anthropometrical parameters; and osteoporotic risk factors were evaluated.

Results: Serum calcium, tALP, osteocalcin, β-2 microglobulin and DPD were significantly different in hyperthyroid group. However there was no difference for any of the study parameters between control and subclinical hyperthyroid group. BMD was similar for all the three groups. Thyroid hormones were correlated with osteocalcin, β-2 microglobulin, tALP, lumbar vertebrae and femur BMD. Osteocalcine and tALP were significantly and negatively correlated with vertebral and femoral total BMD. Homocysteine was not different within groups but significantly correlated with tALP.

Conclusions: There is limited and conflicting data about the effects of subclinical hyperthyroidism on bone turnover in premenopausal period. Despite we could not establish any difference for bone turnover markers between control group and subclinical hyperthyroid patients; with tight correlations between thyroid hormones; we can conclude that subclinical hyperthyroid patients are prone to osteoporosis even in premenopausal period.