Association between long-term levels of thyroid stimulating hormone and bone metabolism in postmenopausal women with subclinical hypothyroidism
Objective:To explore the influence of the long-term levels of thyroid stimulating hormone(TSH)on bone metabolism in postmenopausal women with subclinical hypothyroidism(SCH).Methods:The clinical data of 135 postmenopausal women patients with SCH who were followed up in Endocrine General Specialty Joint Outpatient Clinic Jiangwan Community Health Service Centre of Hongkou District,Shanghai from 2019 to 2022,and the level of TSH in the patients was in the normal range.According to TSH values at low,medium,and high levels,the patients were divided into A,B,and C groups,and the bone turnover indicators and bone density of the patients were compared after 36 months follow-up.Results:There was no significant difference in bone turnover indicators and bone density among the three groups during the follow-up of 24 months(P＞0.05).At 36 months,total type I collagen amino terminal extender peptide(tP1NP)and type I collagen carboxyl terminal peptide β special sequence(β-CTX)in the A group was higher than those in the other two groups(P＜0.01),three bone mineral densities(BMD)of lumbar vertebrae 1-4(L1-4),neck of femur(NECK),and total hip(TOTEL)were lower than those in the other two groups(P＜0.01).The levels of tP1NP and b-CTX in the A group were higher than the basic level at 12 months(P＜0.01),the levels of three BMD was significantly lower than that at the 12 months(P＜0.01).Conclusion:Low levels of TSH within the normal range have an impact on bone metabolism,but there is a time effect relationship.Long term stability of TSH within the median range(1.6 mIU/mL＜TSH＜2.9 mIU/mL)or above is beneficial for bone metabolism stability in patients with SCH and reduces the risk of osteoporosis.
subclinical hypothyroidismpostmenopausalthyroid stimulating hormonebone metabolismbone mineral density
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