Literature DB >> 31702015

Skeletal Effects of Levothyroxine for Subclinical Hypothyroidism in Older Adults: A TRUST Randomized Trial Nested Study.

Elena Gonzalez Rodriguez1,2, Mirah Stuber3, Cinzia Del Giovane3, Martin Feller3,4, Tinh-Hai Collet2, Axel L Löwe3,4, Manuel R Blum4, Nicolien A van Vliet5, Diana van Heemst5, Patricia M Kearney6, Jacobijn Gussekloo7, Simon Mooijaart7, Rudi G J Westendorp8, David J Stott9, Daniel Aeberli10, Douglas C Bauer11, Didier Hans1, Nicolas Rodondi3,4.   

Abstract

CONTEXT: Both thyroid dysfunction and levothyroxine (LT4) therapy have been associated with bone loss, but studies on the effect of LT4 for subclinical hypothyroidism (SHypo) on bone yielded conflicting results.
OBJECTIVE: To assess the effect of LT4 treatment on bone mineral density (BMD), Trabecular Bone Score (TBS), and bone turnover markers (BTMs) in older adults with SHypo. DESIGN AND INTERVENTION: Planned nested substudy of the double-blind placebo-controlled TRUST trial. Participants with SHypo were randomized to LT4 with dose titration versus placebo with computerized mock titration. SETTING AND PARTICIPANTS: 196 community-dwelling adults over 65 years enrolled at the Swiss TRUST sites had baseline and 1-year follow-up bone examinations; 4 participants withdrew due to adverse events not related to treatment. MAIN OUTCOME MEASURES: One-year percentage changes of BMD, TBS, and 2 serum BTMs (serum CTX-1 [sCTX] and procollagen type 1 N-terminal polypeptide [P1NP]). Student's t-test for unadjusted analyses and linear regression adjusted for clinical center and sex were performed.
RESULTS: Mean age was 74.3 years ± 5.7, 45.4% were women, and 19.6% were osteoporotic. The unadjusted 1-year change in lumbar spine BMD was similar between LT4 (+0.8%) and placebo-treated groups (-0.6%; between-groups difference +1.4%: 95% confidence interval [CI] -0.1 to 2.9, P = .059). Likewise, there were no between-group differences in 1-year change in TBS (-1.3%: 95% CI -3.1 to 0.6, P = .19), total hip BMD (-0.2%: 95% CI -1.1 to 0.1, P = .61), or BTMs levels (sCTX +24.1%: 95% CI -7.9 to 56.2, P = .14), or after adjustment for clinical centers and sex.
CONCLUSIONS: Over 1-year levothyroxine had no effect on bone health in older adults with SHypo. REGISTRATION: ClinicalTrial.gov NCT01660126 and NCT02491008. © Endocrine Society 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Entities:  

Year:  2020        PMID: 31702015     DOI: 10.1210/clinem/dgz058

Source DB:  PubMed          Journal:  J Clin Endocrinol Metab        ISSN: 0021-972X            Impact factor:   5.958


  3 in total

1.  Thyroid-stimulating hormone is associated with trabecular bone score and 5-year incident fracture risk in euthyroid postmenopausal women: the OsteoLaus cohort.

Authors:  C Vendrami; P Marques-Vidal; E Gonzalez Rodriguez; D Hans; G Waeber; O Lamy
Journal:  Osteoporos Int       Date:  2021-08-19       Impact factor: 4.507

2.  Effect of Levothyroxine on Older Patients With Subclinical Hypothyroidism: A Systematic Review and Meta-Analysis.

Authors:  Chunyan Zhao; Yueqi Wang; Liu Xiao; Lin Li
Journal:  Front Endocrinol (Lausanne)       Date:  2022-07-14       Impact factor: 6.055

3.  Bone Turnover in Relation to Thyroid-Stimulating Hormone in Hypothyroid Patients on Thyroid Hormone Substitution Therapy.

Authors:  Betty Ann Bjerkreim; Sara S Hammerstad; Erik Fink Eriksen
Journal:  J Thyroid Res       Date:  2022-09-22
  3 in total

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