Yongze Zhang1,2,3,4, Yuzhen Ke1,2,3,4, Lingning Huang1,2,3,4, Ximei Shen1,2,3,4, Sunjie Yan5,6,7,8, Fengying Zhao1,2,3,4, Yimei Li1,2,3,4, Yuxi Lin1,2,3,4. 1. Department of Endocrinology, the First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, 350005, Fujian, China. 2. Clinical Research Center for Metabolic Diseases of Fujian Province, the First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, 350005, Fujian, China. 3. Diabetes Research Institute of Fujian Province, the First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, 350005, Fujian, China. 4. Metabolic Diseases Research Institute, the First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, 350005, Fujian, China. 5. Department of Endocrinology, the First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, 350005, Fujian, China. fjyansunjie@163.com. 6. Clinical Research Center for Metabolic Diseases of Fujian Province, the First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, 350005, Fujian, China. fjyansunjie@163.com. 7. Diabetes Research Institute of Fujian Province, the First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, 350005, Fujian, China. fjyansunjie@163.com. 8. Metabolic Diseases Research Institute, the First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, 350005, Fujian, China. fjyansunjie@163.com.
Abstract
AIM: This study aimed to determine the association of decreased muscle mass with reduced bone mineral density in patients with Graves' disease. METHODS: A total of 758 patients with Graves' disease at diagnosis (mean age 41.2 years) were enrolled for a cross-sectional study; of these, 287 were enrolled for a cohort study with a median follow-up of 24 months. Meanwhile, 1164 age- and sex-matched healthy controls were recruited. All participants underwent dual-energy x-ray absorptiometry and muscle mass index (ASMI) measurements. The changes in ASMI and bone mineral density (BMD) were calculated from the measurements made at a gap of 2 years. RESULTS: The BMD of patients with Graves' disease was still significantly lower after normalizing serum thyroid hormone levels compared with that of healthy controls. ASMI positively correlated with BMD in patients with Graves' disease (lumbar BMD, r = 0.210; femoral neck BMD, r = 0.259; hip BMD, r = 0.235; P < 0.001), and this relationship persisted after successful anti-thyroid therapy (lumbar BMD, r = 0.169; femoral neck BMD, r = 0.281; hip BMD, r = 0.394; P < 0.001). Low muscle mass was associated with low BMD (OR, 1.436; 95% CI, 1.026-2.010). Improving the muscle mass led to changes in the bone mass of the femoral neck (OR, 0.420; 95% CI, 0.194-0.911) and hip (OR, 0.217; 95% CI, 0.092-0.511) during the follow-up. However, this phenomenon was not observed in lumbar and bone turnover markers. CONCLUSIONS: The recovery of bone mass might be related to the recovery of the muscle mass. Patients with Graves' disease should be helped to regain their muscle mass and thus accelerate the recovery of bone mass while administering anti-thyroid therapy.
AIM: This study aimed to determine the association of decreased muscle mass with reduced bone mineral density in patients with Graves' disease. METHODS: A total of 758 patients with Graves' disease at diagnosis (mean age 41.2 years) were enrolled for a cross-sectional study; of these, 287 were enrolled for a cohort study with a median follow-up of 24 months. Meanwhile, 1164 age- and sex-matched healthy controls were recruited. All participants underwent dual-energy x-ray absorptiometry and muscle mass index (ASMI) measurements. The changes in ASMI and bone mineral density (BMD) were calculated from the measurements made at a gap of 2 years. RESULTS: The BMD of patients with Graves' disease was still significantly lower after normalizing serum thyroid hormone levels compared with that of healthy controls. ASMI positively correlated with BMD in patients with Graves' disease (lumbar BMD, r = 0.210; femoral neck BMD, r = 0.259; hip BMD, r = 0.235; P < 0.001), and this relationship persisted after successful anti-thyroid therapy (lumbar BMD, r = 0.169; femoral neck BMD, r = 0.281; hip BMD, r = 0.394; P < 0.001). Low muscle mass was associated with low BMD (OR, 1.436; 95% CI, 1.026-2.010). Improving the muscle mass led to changes in the bone mass of the femoral neck (OR, 0.420; 95% CI, 0.194-0.911) and hip (OR, 0.217; 95% CI, 0.092-0.511) during the follow-up. However, this phenomenon was not observed in lumbar and bone turnover markers. CONCLUSIONS: The recovery of bone mass might be related to the recovery of the muscle mass. Patients with Graves' disease should be helped to regain their muscle mass and thus accelerate the recovery of bone mass while administering anti-thyroid therapy.
Authors: Ingvild Kristine Blom-Høgestøl; Stephen Hewitt; Monica Chahal-Kummen; Cathrine Brunborg; Hanne Løvdal Gulseth; Jon A Kristinsson; Erik Fink Eriksen; Tom Mala Journal: Bone Date: 2019-07-16 Impact factor: 4.398
Authors: S R Cummings; M C Nevitt; W S Browner; K Stone; K M Fox; K E Ensrud; J Cauley; D Black; T M Vogt Journal: N Engl J Med Date: 1995-03-23 Impact factor: 91.245
Authors: Elham Z Movassagh; Adam D G Baxter-Jones; Saija Kontulainen; Susan Whiting; Michael Szafron; Hassan Vatanparast Journal: Nutr J Date: 2018-02-28 Impact factor: 3.271