Bone mineral density in treated at a young age for differentiated thyroid cancer after Chernobyl female patients on TSH-suppressive therapy receiving or not Calcium-D3 supplementation

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Author(s)

    • Leonova Tatiana A.
    • Counseling-diagnostic Department of thyroid diseases, Minsk City Clinical Oncologic Dispensary, Minsk 220013, Belarus
    • Drozd Valentina M.
    • Department of Endocrinology, Belarusian Medical Academy of Post-Graduate Education, Minsk 220013, Belarus
    • Saenko Vladimir A.
    • Department of Health Risk Control, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki 852-8523, Japan
    • Mine Mariko
    • Biostatistics Section, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki 852-8523, Japan
    • Biko Johannes
    • Department of Nuclear Medicine, University of Wuerzburg, Wuerzburg D-97080, Germany
    • Rogounovitch Tatiana I.
    • Department of Global Health, Medicine and Welfare, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki 852-8523, Japan
    • Takamura Noboru
    • Department of Global Health, Medicine and Welfare, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki 852-8523, Japan
    • Reiners Christoph
    • Department of Nuclear Medicine, University of Wuerzburg, Wuerzburg D-97080, Germany
    • Yamashita Shunichi
    • Department of Health Risk Control, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki 852-8523, Japan|Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki 852-8523, Japan

Abstract

Long-term management of patients with differentiated thyroid cancer (DTC) commonly includes TSH-suppressive therapy with L-T4 and, in case of postsurgical hypoparathyroidism, Calcium-D3 supplementation, both of which may affect skeletal health. Experience with female patients treated for DTC at a young age and who were then receiving long-term therapy with L-T4 and Calcium-D3 medication is very limited to date. This cross-sectional study set out to investigate effects of Calcium-D3 supplementation and TSH-suppressive therapy on bone mineral density (BMD) in 124 young female patients treated for DTC at a mean age of 14 years and followed-up for an average of 10 years. BMD was found to be significantly higher in patients receiving Calcium-D3 medication than in patients not taking supplements. The level of ionized calcium was the strongest factor determining lumbar spine BMD in patients not receiving Calcium-D3 supplementation. Pregnancy ending in childbirth and HDL-cholesterol were associated with a weak adverse effect on spine and femoral BMD. No evidence of adverse effects of L-T4 and of radioiodine therapies on BMD was found. We conclude that Calcium-D3 medication has a beneficial effect on BMD, and that TSH-suppressive therapy does not affect BMD in women treated for DTC at young age, at least after 10 years of follow-up.

Journal

  • Endocrine Journal

    Endocrine Journal 62(2), 173-182, 2015

    The Japan Endocrine Society

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