A prospective study of thyroid function, bone loss, and fractures in older men: The MrOS study

被引:51
作者
Waring, Avantika C. [1 ]
Harrison, Stephanie [2 ]
Fink, Howard A. [3 ,4 ]
Samuels, Mary H. [5 ]
Cawthon, Peggy M. [2 ]
Zmuda, Joseph M. [6 ]
Orwoll, Eric S. [5 ]
Bauer, Douglas C. [7 ,8 ]
机构
[1] Univ Calif San Francisco, Div Endocrinol & Metab, San Francisco, CA 94107 USA
[2] Calif Pacific Med Ctr, Res Inst, San Francisco Coordinating Ctr, San Francisco, CA USA
[3] Univ Minnesota, Geriatr Res Educ & Clin Ctr, Minneapolis, MN USA
[4] Vet Affairs Med Ctr, Minneapolis, MN USA
[5] Oregon Hlth & Sci Univ, Dept Med, Div Endocrinol Diabet & Clin Nutr, Portland, OR 97201 USA
[6] Univ Pittsburgh, Dept Epidemiol, Pittsburgh, PA 15261 USA
[7] Univ Calif San Francisco, Dept Med, San Francisco, CA 94107 USA
[8] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94107 USA
基金
美国国家卫生研究院;
关键词
THYROID FUNCTION; OSTEOPOROSIS; MEN; BONE DENSITY; FRACTURE; ISCHEMIC-HEART-DISEASE; MINERAL DENSITY; SUBCLINICAL HYPOTHYROIDISM; OSTEOPOROTIC FRACTURES; SERUM THYROTROPIN; NATURAL COURSE; HIP FRACTURE; RISK-FACTORS; FOLLOW-UP; TSH;
D O I
10.1002/jbmr.1774
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Excess thyroid hormone is associated with increased bone loss and fracture risk in older women, but few data exist for men. We sought to determine if thyroid function is independently associated with bone loss and fracture risk in older men. Data were analyzed from the Osteoporotic Fractures in Men (MrOS) study, a cohort of community-dwelling U.S. men aged 65years and older. Using a case-cohort design, fasting baseline serum archived at 80 degrees C was assayed for thyroid-stimulating hormone (thyrotropin) (TSH) and free thyroxine (FT4) in 397 men with confirmed nonspine fracture, including 157 hip fractures, and 1420 randomly selected men without fracture. TSH and FT4 were analyzed as continuous variables and as thyroid function categories (subclinical hyperthyroid, euthyroid, and subclinical hypothyroid). Hip dual-energy X-ray absorptiometry (DXA) (Hologic QDR4500) was measured at baseline and after a mean follow-up of 4.6years. Incident nonspine fractures were centrally adjudicated. Bone loss was evaluated with multivariate regression methods and fractures risk was evaluated using hazard models that accounted for the case-cohort sampling, adjusted for age, clinic-site, body mass index (BMI), race, physical activity, corticosteroid use, smoking, alcohol intake, and thyroid medication use. In fully adjusted analyses, TSH was not associated with risk of nonspine fracture (relative hazard [RH] 0.92 per SD decrease in TSH; 95% confidence interval [CI], 0.741.14), but was significantly associated with risk of hip fracture (RH 1.31; 95% CI, 1.011.71), which persisted among normal range TSH values (RH 1.21; 95% CI, 1.001.47). There was no association between TSH or FT4 and bone loss, and fracture risk did not differ significantly by thyroid function category. We conclude that although neither TSH nor FT4 are associated with bone loss, lower serum TSH may be associated with an increased risk of hip fractures in older men. (c) 2013 American Society for Bone and Mineral Research.
引用
收藏
页码:472 / 479
页数:8
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