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Background: Patients receiving postoperative radioiodine therapy for advanced differentiated thyroid carcinoma (DTC) are repeatedly in short-term thyroid hormone deficiency, whose bone turnover state is not fully understood.
Methods: Serum bone turnover markers (BTMs), bone specific alkaline phosphatase (BALP), type 1 procollagen N-terminal propeptide (P1NP), osteocalcin (OC), and the β-isomerized C-terminal telopeptide of type 1 collagen (β-CTx) were measured in 50 adult male DTC patients after 4-week suspension of levothyroxine replacement therapy and 40 matched euthyroid controls. Relationships between parameters of thyroid function (free triiodothyronine, FT3; free thyroxine, FT4; thyroid stimulating hormone, TSH) and the BTMs were studied.
Results: The patients had significantly decreased OC (–37.6 %, P<0.001) and β-CTx (–35.5 %, P<0.001) compared with the controls, showing FT3 as the independent risk factor for OC (R²=0.425, P<0.001) and β-CTx (R²=0.124, P<0.001). Partial correlation analysis showed that only FT3 was significantly correlated with OC after controlling FT4 and TSH (r=0.362, P=0.001).
Conclusions: DTC patients have moderately decreased bone turnover after short-term suspension of thyroxine suppressive therapy, with serum FT3 concentration as the predominant and independent risk factor.
DOI: Clin. Lab. 2010;56:87-93
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