Roland Ricken1, Felix Bermpohl2, Peter Schlattmann3, Tom Bschor4, Mazda Adli1, Norbert Mönter5, Michael Bauer6. 1. Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany. 2. Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany; Berlin School of Mind and Brain, Berlin, Germany. 3. Department of Medical Statistics, Informatics and Documentation, University Hospital of Friedrich-Schiller University Jena, Jena, Germany. 4. Department of Psychiatry and Psychotherapy, Schloßparkklinik, Berlin, Germany. 5. Nervenärztlich Psychotherapeutische Praxisgemeinschaft, Tegeler Weg 4; 10589 Berlin, Germany. 6. Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. Electronic address: Michael.Bauer@uniklinikum-dresden.de.
Abstract
BACKGROUND: To investigate the long-term effects of supraphysiological, TSH suppressive doses of levothyroxine (TSDL) on bone mineral density (BMD) in patients with affective disorders during an average treatment duration of 69 months. METHODS: In 22 patients, BMD of the spine (lumbar vertebrae L1-4) and femur (femoral neck) was measured by dual energy X-ray absorptiometry (DXA). Forty (40) measurements from the prior study and 48 new follow-up measurements were included. BMD was expressed as Z-scores as a population standard reference. We used a linear mixed model to investigate the duration of TSDL as an explanatory factor for change in BMD compared to an age and gender matched reference population. RESULTS: We found no significant differences in bone loss between the study and the reference population. The estimated non-significant decrease in Z-score compared to the reference population found was: a) lumbar spine (L1-4): -0.00069/month (p=0.9759) b) neck region of femur: -0.01405/month (p=0.4436). We did not find the factors age, thyroxine-dose or postmenopausal state as predictors for a decline in BMD. LIMITATIONS: Small sample size, no bone density assessment prior to treatment with TSDL, no patient control group with mood disorders who did not receive TSDL, variable bone density follow-up intervals. CONCLUSION: This study did not demonstrate evidence that long-term treatment of affectively ill patients with TSDL accelerates loss of BMD compared to an age- and gender-matched reference population.
BACKGROUND: To investigate the long-term effects of supraphysiological, TSH suppressive doses of levothyroxine (TSDL) on bone mineral density (BMD) in patients with affective disorders during an average treatment duration of 69 months. METHODS: In 22 patients, BMD of the spine (lumbar vertebrae L1-4) and femur (femoral neck) was measured by dual energy X-ray absorptiometry (DXA). Forty (40) measurements from the prior study and 48 new follow-up measurements were included. BMD was expressed as Z-scores as a population standard reference. We used a linear mixed model to investigate the duration of TSDL as an explanatory factor for change in BMD compared to an age and gender matched reference population. RESULTS: We found no significant differences in bone loss between the study and the reference population. The estimated non-significant decrease in Z-score compared to the reference population found was: a) lumbar spine (L1-4): -0.00069/month (p=0.9759) b) neck region of femur: -0.01405/month (p=0.4436). We did not find the factors age, thyroxine-dose or postmenopausal state as predictors for a decline in BMD. LIMITATIONS: Small sample size, no bone density assessment prior to treatment with TSDL, no patient control group with mood disorders who did not receive TSDL, variable bone density follow-up intervals. CONCLUSION: This study did not demonstrate evidence that long-term treatment of affectively ill patients with TSDL accelerates loss of BMD compared to an age- and gender-matched reference population.
Authors: M Bauer; S Berman; T Stamm; M Plotkin; M Adli; M Pilhatsch; E D London; G S Hellemann; P C Whybrow; F Schlagenhauf Journal: Mol Psychiatry Date: 2015-01-20 Impact factor: 15.992
Authors: Maximilian Pilhatsch; Thomas J Stamm; Petra Stahl; Ute Lewitzka; Anne Berghöfer; Cathrin Sauer; Michael Gitlin; Mark A Frye; Peter C Whybrow; Michael Bauer Journal: Int J Bipolar Disord Date: 2019-10-04