Status of bone mineral density in male patients with primary hypothyroidism
Keywords:hypothyroidism, bone mineral density, X-ray densitometry
Background. The issue of hypothyroidism effect on bone tissue is underinvestigated, due to the small number of studies. In addition, it’s not easy to determine the effect of reduced thyroid function on bone strength due to the fact that these patients are usually elderly and have many additional factors for the development of osteoporosis. The purpose of the study is to assess the status of bone mineral density (BMD) in men with hypothyroidism. Materials and methods. We have examined 35 men with primary hypothyroidism aged 28–69 years. Duration of disease (from the time of diagnosis and initiation of thyroid hormone replacement therapy) was 3 to 26 years. The average daily dose of levothyroxine was 125.5 ± 16.5 µg. Patients were in a state of compensation (no complaints and a normal level of thyroidstimulating hormone on the background of hormone therapy). The control group consisted of 25 healthy, clinically euthyroid men aged 25–49 years. Results. Osteopenia of varying severity was detected in 11 (31.4 %), osteoporosis — in 8 (22.9 %) patients, and in the remaining 16 (45.7 %) persons, BMD was within normal limits. When comparing bone density graphs in patients of different age groups, it was found that with age, the frequency and severity of bone loss increases. Duration of disease has the most significant negative effect on the BMD in patients with hypothyroidism. Although the incidence of osteopenia in the group of patients with disease duration from 5 to 15 years is greater (55.0 %) than in persons with disease duration of more than 15 years (41.7 %), but osteoporosis is 2.5 times more likely in patients with longer duration of disease than in people with disease duration of 5–15 years. Conclusions. Violations of bone mineral density, which are manifested in the development of osteopenia and osteoporosis, are observed in 54.3 % of men with primary hypothyroidism. Severity of changes in bone mineral density is directly proportional to the age, duration of thyroid hormone replacement therapy and inversely proportional to the body mass index.
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