S Khamisi1,2, M Lundqvist3,4, A J Rasmusson4, B E Engström3,4, F A Karlsson3,4, Ö Ljunggren3,4. 1. Department of Endocrinology and Diabetes, Uppsala University Hospital, 751 85, Uppsala, Sweden. selwan.khamisi@medsci.uu.se. 2. Department of Medical Sciences, Uppsala University, Uppsala, Sweden. selwan.khamisi@medsci.uu.se. 3. Department of Endocrinology and Diabetes, Uppsala University Hospital, 751 85, Uppsala, Sweden. 4. Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Abstract
PURPOSE: Vitamin D and osteoporosis in Graves' disease (GD) have been examined in cross-sectional studies with divergent results. Here, we prospectively studied vitamin D metabolism and bone health in patients with newly diagnosed GD. METHODS: Thirty consecutive patients with de novo overt thyrotoxicosis diagnosed with GD were included. At diagnosis, none of the patients were treated with vitamin D or anti-osteoporotic drugs. All patients were initially treated with antithyroid drugs. Blood samplings were taken at baseline and at 6 weeks, 3, 6, 12 and 24 months after treatment start. Serum levels of 25OHD3, 1,25OH2D3, calcium, parathyroid hormone (PTH), and C-terminal telopeptides of Type I collagen (CTX-I) were analysed. Bone mineral density (BMD) was measured at baseline, and 1 and 2 years after treatment initiation. RESULTS: At diagnosis, patients with GD did not have vitamin D deficiency. There were no significant correlations between levels of 25OHD3 and thyrotoxicosis. Upon treatment of the thyrotoxicosis, serum calcium fell transiently, and PTH and 1,25OH2D3 increased. 25OHD3 fell within the normal range and stabilised at 6 months. CTX-I fell over 12 months, BMD increased significantly up to 2 years, p = 0.002, < 0.001 and 0.005 in the spine, left total hip and left femoral neck, respectively. CONCLUSIONS: The present data underline that thyrotoxicosis has a negative impact on bone health and demonstrate fine-tuned dynamics in bone and vitamin D metabolism. Upon treatment, bone health improved over a follow-up period of 24 months despite rising PTH. Increased conversion of 25OHD3 to 1,25OH2D3 occurs during treatment of GD.
PURPOSE: Vitamin D and osteoporosis in Graves' disease (GD) have been examined in cross-sectional studies with divergent results. Here, we prospectively studied vitamin D metabolism and bone health in patients with newly diagnosed GD. METHODS: Thirty consecutive patients with de novo overt thyrotoxicosis diagnosed with GD were included. At diagnosis, none of the patients were treated with vitamin D or anti-osteoporotic drugs. All patients were initially treated with antithyroid drugs. Blood samplings were taken at baseline and at 6 weeks, 3, 6, 12 and 24 months after treatment start. Serum levels of 25OHD3, 1,25OH2D3, calcium, parathyroid hormone (PTH), and C-terminal telopeptides of Type I collagen (CTX-I) were analysed. Bone mineral density (BMD) was measured at baseline, and 1 and 2 years after treatment initiation. RESULTS: At diagnosis, patients with GD did not have vitamin D deficiency. There were no significant correlations between levels of 25OHD3 and thyrotoxicosis. Upon treatment of the thyrotoxicosis, serum calcium fell transiently, and PTH and 1,25OH2D3 increased. 25OHD3 fell within the normal range and stabilised at 6 months. CTX-I fell over 12 months, BMD increased significantly up to 2 years, p = 0.002, < 0.001 and 0.005 in the spine, left total hip and left femoral neck, respectively. CONCLUSIONS: The present data underline that thyrotoxicosis has a negative impact on bone health and demonstrate fine-tuned dynamics in bone and vitamin D metabolism. Upon treatment, bone health improved over a follow-up period of 24 months despite rising PTH. Increased conversion of 25OHD3 to 1,25OH2D3 occurs during treatment of GD.
Authors: Won Young Lee; Ki Won Oh; Eun Jung Rhee; Chan Hee Jung; Sun Woo Kim; Eun Joo Yun; Hyun Jung Tae; Ki Hyun Baek; Moo Il Kang; Moon Gi Choi; Hyung Joon Yoo; Sung Woo Park Journal: Arch Med Res Date: 2006-05 Impact factor: 2.235
Authors: Mirna Abraham-Nordling; Kristina Byström; Ove Törring; Mikael Lantz; Gertrud Berg; Jan Calissendorff; Helena Filipsson Nyström; Svante Jansson; Gun Jörneskog; F Anders Karlsson; Ernst Nyström; Hans Ohrling; Thomas Orn; Bengt Hallengren; Göran Wallin Journal: Eur J Endocrinol Date: 2011-09-09 Impact factor: 6.664