The Effect Of TSH Suppressive Therapy For Differentiated Thyroid Carcinoma On Bone Mineral Density

Objective: To analyze influence of TSH suppressive therapy for differentiated thyroid carcinoma on patients' bone mineral density.Method: Follow-up data of 183 cases of thyroid papillary carcinoma after surgery was collected.Thyroid stimulating hormone,three free triiodothyronine,free thyroxine,PTH,serum calcium and bone density were tested in all patients,estrogen,follicle stimulating test were tested in female patients.Groups were set according to different level and period of TSH suppressive therapy.The effects of TSH suppressive therapy on bone mineral density were compared among three individuals(male,premenopausal women and postmenopausal women);Female patients were average divided into high hormone levels,moderate hormone levels and low hormone levels based on different estrogen and FSH levels.The differences of the female bone density in three different hormone levels were compared.Results: Different level of TSH treatment had an influence on bone mineral density of postmenopausal women(P<0.05).On site at the lumbar spine,TSH >0.372 m IU/L group has the highest level of bone mineral density(1.105±0.103g/cm~2),TSH<0.1m IU/L group has the lowest level of bone mineral density(0.970±0.115g/cm~2),0.1m IU/L?TSH?0.372 m IU/L group has the moderate level of bone mineral density(1.005±0.128g/cm~2).Different period of TSH treatment had no influence on bone mineral density of postmenopausal women.TSH suppressive therapy showed no significant difference on bone mineral density of men and premenopausal women.At TSH<0.1m IU/L and 0.1?TSH ?0.372 m IU/L suppressive level,sites of bone mineral density increased with E2 level,which was statistically significant(P<0.05).While at TSH>0.372 m IU/L suppressive level,bone mineral density in all sites were similar between groups.At TSH<0.1m IU/L and 0.1?TSH ?0.372 m IU/L suppressive level,sites of bone mineral density had a negative correlation with FSH level,which was statistically significant(P<0.05).While at TSH>0.372 m IU/L suppressive level,bone mineral density in all sites were similar between groups.Conclusion: The effect of TSH suppressive therapy on bone mineral density of postmenopausal women is obvious;The effect of TSH suppressive therapy on bone mineral density of men and premenopausal women is not obvious;The bone mineral density of female patients is more susceptible to the changes of sex hormones at intensive TSH suppressive therapy.