Changes in Bone Metabolism in Juvenile Hyperthyroidism
Year: 2021
Type: article
Study design: Observational Study
Abstract: Background: The development of the skeletal system occur during childhood. Thyroid hormones play an important role in the skeleton's normal growth, maturation, and maintenance of the structure and mass of bones. Aimed: identify abnormalities in bone mineral density and the level of calciotropic hormones in juvenile hyperthyroidism to further improve the diagnosis of hyperthyroidism complications on bone metabolism. Methods: The study was conducted by 23 health controls and 71 children and adolescents with hyperthyroidism. All studies were conducted in the Republican Specialized Scientific-Practical Medical Center of Endocrinology, Uzbekistan. Thyroid status and thyroid antibodies, osteocalcin, parathyroid hormone, vitamin D, calcium, phosphorus, alkaline phosphatase were determined using a closed-type immunochemistry analyzer Cobas e 411 Hitachi company Hoffman Le Roche (Switzerland) and its reagents. Bone mineral density was evaluated by dual-energy absorptiometry on a Stratos X-ray densitometer from Diagnostic Medical Systems, France. The results: 59.2% of children with hyperthyroidism were found to be underweight, there was a tendency to accelerated linear growth, low weight and body mass index, and 12.7% were tall. In juvenile hyperthyroidism, in comparison with the control, significantly low values of vitamin D and calcium in the blood serum were noted, the mean values of osteocalcin and alkaline phosphatase were substantially higher. Simultaneously, there was no significant difference in the levels of parathyroid hormone and phosphorus in the blood serum in the compared groups. In 45.1% of patients, a decrease in bone mass was diagnosed compared to the age norm. A reliable direct correlation of vitamin D and calcium with bone density was revealed in all X-ray densitometry parameters and a reliable inverse correlation of osteocalcin, alkaline phosphatase and bone mineral density, as well as Z-scores. Osteocalcin had a stronger inverse correlation with all dual-energy X-ray absorptiometry parameters and became a better biomarker than alkaline phosphatase. Conclusions: There is a decrease in bone mineral density in children and adolescents with hyperthyroidism. Changes in the level of calciotropic hormones indicate a deranged bone metabolism. Serum osteocalcin can be used as a biomarker of bone metabolism in children and adolescents with hyperthyroidism. It is recommended to assess the bones' condition during the initial examination of children and adolescents with hyperthyroidism.
Author: Muratova Shakhlo
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W3167117305