J Bone Metab.  2019 Feb;26(1):45-50. 10.11005/jbm.2019.26.1.45.

Risk of Osteoporotic Fractures after Thyroid-stimulating Hormone Suppression Therapy in Patients with Thyroid Cancer

Affiliations
  • 1Department of Internal Medicine, Center for Thyroid Cancer, National Cancer Center, Goyang, Korea.
  • 2Department of Orthopaedic Surgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, Korea.
  • 3Department of Surgery, National Cancer Center, Goyang, Korea.
  • 4Department of Obstetrics and Gynecology, National Cancer Center, Goyang, Korea.
  • 5Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea. ykleemd@gmail.com

Abstract

BACKGROUND
The effects of subclinical hyperthyroidism on fracture risk induced by thyroid-stimulating hormone (TSH) suppression therapy in patients with thyroid cancer still remains controversial. We performed a meta-analysis and systematic review to evaluate the effects of TSH suppression therapy on osteoporotic fracture in patients with thyroid cancer.
METHODS
We performed a systematic search to identify studies which included osteoporotic fractures (hip fracture and vertebral fracture) in patients on TSH suppression therapy for thyroid cancer. Main outcome measures were occurrence and risk of osteoporotic fractures including hip and vertebral fractures between patients and controls.
RESULTS
A systematic search yielded a total of 8 studies appropriate for review which included osteoporotic fracture outcome in patients on TSH suppression therapy for thyroid cancer. Studies with larger number of subjects showed the higher risk of osteoporotic fracture in group with TSH suppression therapy, although studies with smaller sample size presented a similar risk of fracture with control group.
CONCLUSIONS
Although studies were limited by small numbers, results suggested possible association between chronic TSH suppression therapy and the increased risk of osteoporotic fractures in patients with thyroid cancer.

Keyword

Osteoporotic fractures; Thyroid neoplasms; Thyrotropin

MeSH Terms

Hip
Humans
Hyperthyroidism
Osteoporotic Fractures*
Outcome Assessment (Health Care)
Sample Size
Thyroid Gland*
Thyroid Neoplasms*
Thyrotropin*
Thyrotropin
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