Changes in Bone Tissues and Their Age-Related Differences in Women with Diffuse Toxic Goiter

L.V. Herasymenko


The aim of the research was to study the risk factors which favor formation of structural and functional disorders of osseous tissue at thyrotoxicosis and to estimate diagnostic value of x-ray morphometric examination and ultrasound densitometry at early identification of osteoporotic processes. We examined 170 females of reproductive age and at menopausal period, first of all with diagnosis of diffuse toxic goiter. All these women were divided into three subgroups depending on the intensity of their osteoporotic changes (the patients with diffuse toxic goiter without evidence of changes in bone tissue; the patients with diffuse toxic goiter and osteopenia; and the patients with diffuse toxic goiter and osteoporosis). A control group included the healthy women of the both age groups which were divided into the same subgroups.
It has been established that radiographic method which is used to reveal osteoporotic changes in women of different age groups with diffuse toxic goiter (including determination of indexes of the vertebrae deformation such as Rokhlin index, Scharmazanova index, metacarpal index) allows evaluate the condition of the bone tissue on the first stage of examination. Nevertheless, this method doesn’t pertain to the most highly informative techniques.
The evaluation of mineral density indexes of bone tissue by ultrasound osseous densitometry is more modern and informative method. The present study revealed that osteopenia and osteoporosis are associated with loss of the density of the heel bone in females of the both age groups, either in case of presence of diffuse toxic goiter or without it. Nevertheless the percentage share of the density loss depends both on age and presence of diffuse toxic goiter.
In reproductive age the mineral density of the bone tissue in osteopenia is not complicated with diffuse toxic goiter but in osteoporosis the fact of presence of thyroid pathology additionally impact the bone structure.
Loss of density of the heel bone in menopausal women shows the same tendency as in the women of reproductive age.
It has been proved that decrease in density of the heel bone up to stage of osteopenia does not depend on the diagnosed diffuse toxic goiter. Meanwhile, the more serious changes in density connected with the degree of osteoporosis have no correlation with the diffuse toxic goiter, and are observed in the age group of menopausal women.
The diffuse toxic goiter balances these age differences in the mentioned parameter: both in reproductive period and in menopausal period the loss of density in osteoporosis is of approximately 35 %. So identification of primary impairment of mineral density of the bone tissue is likely to help in prevention of the development of the further destruction in bone tissue which is connected with thyroid status. It may be supposed that normalizing of the thyroid state may stop the process of destruction in the bone tissue.
It has been revealed that in the groups of patients with osteopenia and osteoporosis the reduced mineral density of the bone tissue is associated with certain statistically significant differences in bone density in the women of both subgroups (with diffuse toxic goiter and without it) as well as in the velocity of ultrasound transmission and changes of wide-band ultrasound reduction. The revealed data indicate the changes in quantity, sizes and dimensional orientation of bone trabecules in the examined bone in the above mentioned patients being observed.
The analysis of mineral density of the bone tissue by T-score parameter allowed reveal certain age differences among the groups with no thyroid pathology but with osteoporosis.


diffuse toxic goiter; osteopenia; osteoporosis; mineral density of the bone tissue; reproductive age; menopausal period


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