Ultrasound Densitometry in the Diagnosis of Disorders of Bone Mineral Density in Patients with Thyroid Pathology
The objective of this study was to establish the relationship between the levels of thyroid hormones and characteristics of bone tissue according to radiological and laboratory methods. To assess the influence of thyroid hormone levels on the bone tissue, there was performed a comparative study of four groups of patients aged 19 to 49 years. The main study groups consisted of 34 patients with diffuse toxic goiter (DTG) and 42 patients with overt primary hypothyroidism. A comparison group included 23 patients with diffuse nontoxic goiter and preserved functional state of the thyroid gland (indicators of thyroid-stimulating hormone (TSH) and fT4 were not statistically significantly different from the control group data). The control group is presented by 20 apparently healthy persons. It was found that excessive production of thyroid hormone with a pronounced inhibition of TSH (0.08 ± 0.03 µIU/ml) in patients with DTG, as well as reduced thyroid function with higher levels of TSH (8.24 ± 3.16 µIU/ml) in patients with overt hypothyroidism, lead to disturbances in the system of bone metabolism: in thyrotoxicosis — increase with the predominance of resorption, and in hypothyroidism — decrease of bone remodeling. Ultrasonic densitometry has shown a statistically significant decrease of bone density values and increased incidence of osteopenia and osteoporosis compared to apparently healthy individuals. The development of hyperthyroidism in the age under 30 increases the risk of osteopenic syndrome in patients with DTG. The incidence of osteopenic syndrome in patients with overt hypothyroidism does not depend on age.
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