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CORRESPONDENCE
Year : 2012  |  Volume : 136  |  Issue : 2  |  Page : 309

Changes in markers of bone turnover during treatment of hyperthyroidism


Yildirim Beyazit University Medical School, Ataturk Teaching & Research Hospital, Department of Endocrinology, Bilkent, Ankara, Turkey

Date of Web Publication7-Sep-2012

Correspondence Address:
Eda Demir Onal
Ceyhun Atuf Kansu Cad Ehl-i BeytMah 1268. Sok 10/6, TR-06520, Balgat, Çankaya, Ankara
Turkey
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Source of Support: None, Conflict of Interest: None


PMID: 22960904

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How to cite this article:
Onal ED. Changes in markers of bone turnover during treatment of hyperthyroidism. Indian J Med Res 2012;136:309

How to cite this URL:
Onal ED. Changes in markers of bone turnover during treatment of hyperthyroidism. Indian J Med Res [serial online] 2012 [cited 2019 Aug 21];136:309. Available from: http://www.ijmr.org.in/text.asp?2012/136/2/309/100799

Sir,

I read with great interest the article by Jyotsna et al[1] . They undertook a study to measure the bone mineral density (BMD) in patients with Graves disease in Indian population which is predominantly vitamin D deficient and to assess the changes in BMD after the patients became and remained euthyroid following treatment. BMD was found to be significantly lower at hip, spine and fore arm compared to healthy, euthyroid controls. When treated for hyperthyroidism, the absolute BMD improved at all sites. But the BMD corrected for body mass index showed a decrease which stabilized after one year. The authors concluded that damage in BMD caused by thyroid hormone excess was not corrected even after two years of patients being euthyroid [1] .

Biochemical markers that reflect remodelling or turnover of bone can be measured in urine or blood including resorption markers and formation markers. Resorption markers include tartrate resistant acid phosphatase and bone matrix degradation products like hydroxyproline, pyridinium cross-links, and telopeptides [2] . Bone formation markers include alkaline phosphatase enzyme, and three products of bone matrix synthesis which are osteocalcin, amino- and carboxy-terminal procollagen l extension peptide [3] .

Thyroid hormones affect bone cells both in vitro and in vivo by stimulating osteoblast and osteoclast cells with more bone resorption and increased skeletal remodelling. It was reported that bone resorption markers, such as urinary pyridinoline and deoxypyridinoline, were increased 7-8 times in hyperthyroidism than age and sex matched controls [4] . On the other hand, levels of bone formation markers increased to a less degree suggesting the imbalance between bone formation and resorption with subsequent bone loss in hyperthyroidism [4],[5] . It was shown that the increased levels of markers of bone turnover declined during antithyroid treatment [4] .

It is felt that measurement of several bone formation and resorption markers in addition to serum calcium and alkaline phosphatase could have been an original contribution to the design of the present study under the light of the pertinent data in the literature.

 
   References Top

1.Jyotsna VP, Sahoo A, Ksh SA, Sreenivas V, Gupta N. Bone mineral density in patients of Graves disease pre- & post-treatment in a predominantly vitamin D deficient population. Indian J Med Res 2012; 135 : 36-41.  Back to cited text no. 1
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2.Kraenzlin ME, Seibel M. Measurement of biochemical markers of bone resorption. In: Seibel M, Robins S, Bilezikian J, editors. Dynamics in bone and cartilage metabolism. San Diego: Academic Press; 2006. p. 541-64.  Back to cited text no. 2
    
3.Naylor KE, Eastell R. Measurement of biochemical markers of bone formation. In: Seibel M, Robins S, Bilezikian J, editors. Dynamics of bone and cartilage metabolism. San Diego: Academic Press; 2006. p. 529-40.  Back to cited text no. 3
    
4.Van de ven AC, Erdtsieck RJ. Changes of bone mineral density, quantitative ultrasound parameters and markers of bone turnover during treatment of hyperthyroidism. Neth J Med 2008; 66 : 428-32.  Back to cited text no. 4
    
5.Akalin A, Colak O, Alatas O, Efe B. Bone remodelling markers and serum cytokines in patients with hyperthyroidism. Clin Endocrinol (Oxf) 2002; 57 : 125-9.  Back to cited text no. 5
    




 

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