Serum osteoprotegerin and soluble receptor activator of nuclear factor kappaB ligand levels in patients with a history of differentiated thyroid carcinoma: a case-controlled cohort study.

Abstract

Overt hyperthyroidism is associated with changes in bone metabolism, whereas the effect of levothyroxine (L-T4) load in patients with differentiated thyroid carcinoma (DTC) is controversial. The aim of our study was to evaluate osteoprotegerin (OPG) and soluble receptor activator of nuclear factor kappaB ligand (RANK-L) in patients with DTC with suppressed endogenous thyrotropin due to L-T4 regimen. A cohort of 80 subjects with DTC (68 women and 12 men; age range, 27-81 years) was studied. A cohort of 55 subjects with a history of partial or total surgery for nonmalignant thyroid pathology served as a control group. Groups were matched for sex, age, and body mass index. Per-week dosage of L-T4 was significantly higher in patients with DTC than in controls (P < .001). More elevated free T(4) concentrations (P < .001) and more suppressed thyrotropin and thyroglobulin levels (P < .001) were found in subjects with DTC than in controls. No difference in serum or urinary parameters related to bone metabolism or dual-energy x-ray absorptiometry was noted between the groups. Overall, OPG levels were similar in both groups but were significantly (P = .03) lower in postmenopausal women with DTC than in postmenopausal control women. Only control women showed lower OPG levels in premenopausal than in postmenopausal (P = .002) conditions. Overall, RANK-L levels were significantly higher (P = .03) in subjects with DTC than in controls. In both groups, OPG and RANK-L levels were unrelated to each other. A significant positive correlation was seen between OPG levels and age in both subjects with DTC (P < .001) and controls (P < .001). Serum RANK-L correlated negatively with age in subjects with DTC (P = .05). Although there were several differences in L-T4 dosages, OPG and RANK-L levels were similar in patients with a history of DTC and those with a history of nonmalignant thyroid diseases. The correlation between circulating OPG and RANK-L levels was not significant. The increase in OPG with age indicates its protective role in bone loss. The cause of bone loss after long-term L-T4 load will be more extensively studied.

• Authors: Massimo Giusti, Francesca Cecoli, Laura Fazzuoli, Vincenzina De Franchis, Enrica Ceresola, Diego Ferone, Michele Mussap, Francesco Minuto
• Journal: Metabolism: clinical and experimental (Metabolism) Vol. 56 Issue 5 Pg. 699-707 (May 2007) ISSN: 0026-0495 [Print] United States
• PMID: 17445547 (Publication Type: Journal Article)

Chemical References

• Osteoprotegerin
• Parathyroid Hormone
• RANK Ligand
• Thyroid Hormones
• Phosphorus
• Thyrotropin
• Creatinine
• Alkaline Phosphatase
• Thyroxine
• Calcium

Topics

• Adult
• Age Factors
• Aged
• Aged, 80 and over
• Alkaline Phosphatase (blood)
• Bone and Bones (drug effects, metabolism)
• Calcium (blood, urine)
• Case-Control Studies
• Cohort Studies
• Creatinine (blood, urine)
• Dose-Response Relationship, Drug
• Female
• Humans
• Male
• Middle Aged
• Osteoprotegerin (blood)
• Parathyroid Hormone (blood)
• Phosphorus (blood)
• RANK Ligand (blood)
• Thyroid Hormones (blood)
• Thyroid Neoplasms (blood, drug therapy, urine)
• Thyrotropin (antagonists & inhibitors)
• Thyroxine (administration & dosage)