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Changes in bone density and microarchitecture following treatment of Graves' disease and the effects of vitamin D supplementation. A randomized clinical trial.
Grove-Laugesen, Diana; Ebbehoj, Eva; Watt, Torquil; Hansen, Klavs Würgler; Rejnmark, Lars.
Afiliación
  • Grove-Laugesen D; Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark. dianagrove@clin.au.dk.
  • Ebbehoj E; Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
  • Watt T; Department of Endocrinology and Metabolism, Rigshospitalet, Copenhagen, Denmark.
  • Hansen KW; Diagnostic Centre, Silkeborg Regional Hospital, Silkeborg, Denmark.
  • Rejnmark L; Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
Osteoporos Int ; 2024 Sep 12.
Article en En | MEDLINE | ID: mdl-39264438
ABSTRACT
Thyrotoxicosis leads to loss of bone mass. Vitamin D is important to bone health. In this randomized, placebo-controlled trial, we showed that bone restoration did not improve when adding vitamin D supplementation to standard care of Graves' disease thyrotoxicosis. Bone density and microarchitecture improved markedly with treatment of thyrotoxicosis.

PURPOSE:

Vitamin D is important to skeletal health and ensuring a replete vitamin D status is recommended. In thyrotoxicosis, bone turnover is increased and bone mass density (BMD) reduced. We examined whether vitamin D supplementation improves bone recovery in thyrotoxicosis caused by Graves' disease (GD).

METHODS:

Using a double-blinded design, hyperthyroid patients with GD were randomized to vitamin D3 70 µg/day (2800 IU) or similar placebo as add-on to antithyroid drugs (ATD). At baseline and 9 months, we measured BMD and bone architecture using DXA and high resolution peripheral quantitative computerized tomography. Bone turnover markers (BTM) were measured at 3 months also. Effect of vitamin D versus placebo and the response to ATD treatment were analyzed using linear mixed modelling.

RESULTS:

Eighty-six GD patients were included (age 41 ± 14 years, 86% females). Compared to placebo, vitamin D3 did not improve BMD or microarchitecture. In response to ATD, BMD increased in the hip by 2% (95%CI 1-4%). Cortical porosity decreased in tibia (- 7% [95%CI - 12 to - 2%]) and radius [- 14% [95%CI - 24 to - 3%]), and trabecular thickness increased (tibia (5% [95%CI 2 - 9%]) and radius (4% [95%CI 1-7%]). Changes in BTM, but not thyroid hormones, were associated with changes in BMD by DXA and with changes in the cortical compartment.

CONCLUSION:

In newly diagnosed GD, 9 months of high dose vitamin D3 supplementation does not offer benefit by improving skeletal health. Treatment of thyrotoxicosis is associated with the recovery of BMD and microarchitecture. GOV IDENTIFIER NCT02384668.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Osteoporos Int Asunto de la revista: METABOLISMO / ORTOPEDIA Año: 2024 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Osteoporos Int Asunto de la revista: METABOLISMO / ORTOPEDIA Año: 2024 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Reino Unido