Details
Category: Volume 06 Issue 03 March 2018
Hits: 1505

Title: Bone Mineral status in newly Diagnosed Hyperthyroid Patients

Author: Dr Vijayalakshmi. Ravella

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i3.76

Abstract

Hyperthyroidism is a common disorder affecting a large group of population and is a cause of the osteoporosis. Bone homeostasis abnormalities in patients with hyper thyroidism causes alteration in serum calcium and phosphorous levels. The aim of the present study is to evaluate the levels of bone minerals like calcium and phosphorous in newly diagnosed hyperthyroid subjects and controls. Total T3, T4, TSH, serum calcium and phosphorous levels were estimated. BMI was also measured for both controls and hyperthyroid patients. Total T3, T4, serum calcium and phosphorous levels have been found to be significantly higher where as TSH and BMI have been found to be significantly lower in hyper thyroid patients when compared to controls. Serum calcium and phosphorous levels elevated in hyperthyroidism patients. Elevated T3,T4 levels in hyperthyroidism causes the osteoclast formation by stimulating nuclear receptors leading to bone resorption, which results in high serum calcium levels by moving calcium from bone. Excessive tissue catabolism and decreased renal phosphate excretion causes increase in phosphorous levels.

Keywords:  Calcium, Hyperthyroidism, Phosphorous.

References

  1. Kobe N, J Takamatsui, M Ito, S Sakaneand W Ohsawa. Acute and early effects of triodothyronine administration on serum markers of bone and mineral metabolism. 1999 Endocrine 10: 53-56.
  2. Vestergaard P, Mosekilde L). Hyperthyroidism, bone mineral, and fracture risk: a meta-analysis. Thyroid 2003; 13: 585-93.
  3. Harvey RD, McHardy KC, Reid IW, Paterson F. Measurement ofbone collagen degradation in hyperthyroidism and during thyroxine replacement therapy using pyridinium crosslinks as specific urinary markers. J ClinEndocrinolMetab1991; 72: 1189-94.
  4. Anthony PW, Weetman MD. Graves' disease and Raves' disease. The NEJM 2000; 17: 1236-48.
  5. Greenspan SL, Greenspan FS. The effect of thyroid hormone on skeletal integrity. Ann Intern Med 1999; 130:750–758.
  6. Isaia GC, Roggia C, Gola D, Stefano MD, Gallone G, Aimo G, Ardissone P, Mussetta M. Bone turnover in hyperthyroidism before and after thyrostatic management. J Endocrinol Invest 1999; 23:727–731.
  7. Pantazi H and Papapetrou PD. Changes in parameters of bone and mineral metabolism during therapy for hyperthyroidism. J Clin Endocrinol Metab 2000;85:1099–1106.
  8. P Tofighi, P Shoushtarizadeh, A Hossein-nezhad, V Haghpanah, B Rajabi-pour, Khadabi, S Sharghi, B Larijani. Bone Markers Status in Graves’ disease before and after Treatment. Iranian Journal ofpublic health 2008;1: 30-35.
  9. Udayakumar N, Chandrasekaran M, Rasheed MH, Suresh RV, Sivaprakash S. Evaluation of bone mineral density in thyrotoxicosis. Singapore med J 2006; 47(11) 947.
  10. Gurcan Kisakol, Ahmet Kaya, SaitGonen and Recep Tunc. Bone and calcium metabolism in sub clinical auto immune hyperthyroidismand hypothyroidism.  Endocrine Journal 2003;50(6): 657-661.
  11. Akalin A, Colak O, Atlas O, Efe B. Bone remodelling Markers  and Serum    Cytok-ines In Patients With Hyperthyroidism. Clin Endocrinol 2002;57 :125-129.
  12. Bente L Langdahl and Erik F Eriksen. The influence of thyroid hormones on bone turnover in health and osteopetrosis. EuropeanJournal of Endocrinology 1998; 139:10–11.
  13. Wen-xiaGu, Paula H Stern, Laird D Madison, and Guo-Guang Du. Mutual Up-Regulation of Thyroid Hormone and Parathyroid Hormone Receptors in Rat Osteoblastic Osteosarcoma 17/2.8 Cells. The Endocrine Society 2001;142: 157-164.
  14. R Rizzoli, J-P Bonjour and SL Ferrari. Osteoporosis, genetics and hormones. Journal of Molecular Endocrinology 2001; 26: 79–94.
  15. Nikolaos Stathatos and Leonard Wartofsky. Effects of Thyroid Hormone on Bone. Clinical Reviews in Bone and Mineral Metabolism 2004; 2: 135–150.
  16. A Caroline Heijckmann, Maya SP Huijberts, Piet Geusens, Jolanda de Vries, Paul PCA Menheere and Bruce HR Wolffenbuttel. Hip bone mineral density, bone turnover and risk of fracture in patients on long-term suppressive l-thyroxine therapy for differentiated thyroid carcinoma. European Journal of Endocrinology 2005; 153: 23–29.
  17. Ramesh C. Khanaland Ilka Nemere. Regulation of Intestinal Calcium Transport.Annu Rev Nutr2008;28:179–96.
  18. Adriana V Pérez, Gabriela Picotto,Agata R. Carpentieri, María A Rivoira, María E Peralta López, Nori G Tolosa De Talamoni. Minireview On Regulation Of Intestinal calcium Absorption. Digestion 2008;77:22–34.
  19. Felix Bronher. Current Concepts of Calcium Absorption: An Overview.J Nutr 1992;122: 641-643.
  20. Felix Vargas, Juan Manuel Moreno, Isabel Rodrıguez-Gomez, et al.Vascular and renal function in experimental thyroid disorders European Journal of Endocrinology 2006;154: 197–212.
  21. Mosekide L, Christensen MS: Deceased parathyroid function in hyperthyroidism: inter relationship between serum parathyroid hormone, calcium phosphorus metabolism and thyroid function. Acta Endocrinol 1977:84:566-575.
  22. Mundy GR, Shapiro JL, Bandelin JG, Canalis EM, Raisz LG. Direct stimulation of bone resorption by thyroid hormones. J Clin Invest 1976: 58:529–534.
  23. Sorribas V, Markovich D, Verri T, Biber J, Murer H. Thyroid hormonestimulation of Na/Pi-cotransport in opossum kidney cells. Pflugers Arch 1995: 431:266–271.
  24. Castro JH, Genuth SM, Klein L. Comparative response to parathyroidh-ormone in hyperthyroidism and hypothyr-oidism. Metabolism 1975: 24:839–848.
  25. Cardoso LF, Maciel LM, Paula FJ. The multiple effects of thyroiddisorders on bone and mineral metabolism. Arq Bras Endocrinol Metabol 2014; 58:452–63.

Corresponding Author

Dr Vijayalakshmi. Ravella

Phone Number:  094403 27375, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.