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Impaired sensitivity to thyroid hormone correlates to osteoporosis and fractures in euthyroid individuals

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Abstract

Background

There is growing evidence that thyroid function affects bone metabolism and even fractures risk. However, little is known about the relationship between thyroid sensitivity and osteoporosis and fractures. Therefore, we explored the relationship between thyroid sensitivity-related indices and bone mineral density (BMD) and fractures in euthyroid US adults.

Methods

In this cross-sectional study, 20,686 subjects from National Health and Nutrition Examination Survey (NHANES) data were extracted and analyzed during 2007 to 2010. A total of 3403 men and postmenopausal women aged 50 years or older with available data on diagnosis of osteoporosis and/or fragility fractures, bone mineral density (BMD) and thyroid function, were eligible. TSH index (TSHI), thyrotrophin T4/T3 resistance index (TT4RI/TT3RI), Thyroid feedback quantile-based index (TFQI), Parametric TFQI (PTFQI), free triiodothyronine to free thyroxine ratio (FT3/FT4), the secretory capacity of the thyroid gland (SPINA-GT) and the sum activity of peripheral deiodinases (SPINA-GD) were calculated.

Results

FT3/FT4, SPINA-GD, FT4, TSHI, TT4RI, TFQI and PTFQIFT4 were significantly correlated with BMD (P < 0.001). Multiple linear regression analysis showed that FT3/FT4 and SPINA-GD was significantly positively associated with BMD, while FT4, TSHI, TT4RI, TFQI and PTFQIFT4 were negatively associated with BMD (P < 0.05 or P < 0.001). In logistic regression analysis, the odds ratio (OR) for osteoporosis of TSHI, TFQI and PTFQIFT4 were 1.314(1.076, 1.605), 1.743(1.327, 2.288) and 1.827(1.359, 2.455) respectively, and were 0.746(0.620, 0.898) for FT3/FT4 (P < 0.05).

Conclusions

In elderly euthyroid individuals, impaired sensitivity to thyroid hormones correlates to osteoporosis and fractures, independent of other conventional risk factors.

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Data availability

The original contributions presented in the study are included in the article. Further inquiries can be directed to the corresponding author.

Abbreviations

BMD:

Bone mineral density

FT3:

Free triiodothyronine

FT4:

Free thyroxine

TH:

Thyroid hormone

FT3/FT4:

FT3 to FT4 ratio

TSHI:

TSH index

TT4RI:

Thyrotrophin T4 resistance index

TT3RI:

Thyrotrophin T3 resistance index

TFQI:

Thyroid feedback quantile-based index

PTFQIFT4 :

Parametric Thyroid Feedback Quantile-based Index calculated by FT4

PTFQIFT3 :

Parametric Thyroid Feedback Quantile-based Index calculated by FT3

SPINA-GD:

The sum activity of peripheral deiodinases

SPINA-GT:

The secretory capacity of the thyroid gland

PIR:

Ratio of family income to poverty

BMI:

Body mass index

SBP:

Systolic blood pressure

DBP:

Diastolic blood pressure

HbA1c:

Glycated hemoglobin

TG:

Triglyceride

TC:

Total cholesterol

HDL-C:

High-density lipoprotein cholesterol

LDL-C:

Low-density lipoprotein cholesterol

UA:

Uric acid

RTH:

Thyroid hormone resistance

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Funding

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Author information

Authors and Affiliations

  1. Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Xiang, Beijing, 100730, China

    C. Liu & Z. Xin

  2. Department of Mathematics, School of Biomedical Engineering, Capital Medical University, Beijing, China

    L. Hua

  3. Capital Medical University, Beijing, China

    K. Liu

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Contributions

CL extracted data from NHANES database. ZX and CL conceived the idea for the study and wrote the manuscript. CL, LH and KL conducted data analysis. All authors read and approved the final manuscript. All authors contributed to the article and approved the submitted version.

Corresponding author

Correspondence to Z. Xin.

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The studies involving human participants were reviewed and approved by NHANES.

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Liu, C., Hua, L., Liu, K. et al. Impaired sensitivity to thyroid hormone correlates to osteoporosis and fractures in euthyroid individuals. J Endocrinol Invest 46, 2017–2029 (2023). https://doi.org/10.1007/s40618-023-02035-1

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  • DOI: https://doi.org/10.1007/s40618-023-02035-1

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