Longitudinal changes of biochemical markers and bone mineral density in hyperthyroid patients during antithyroid drug therapy / Journal of Rural Medicine

ABSTRACT

Objective: The aim of the present study was to clarify whether patients with Graves' disease who have lost bone mass can restore bone mass to age-matched control levels by antithyroid drug therapy.Patient/Materials and Methods: One male and 16 female patients (aged 21-71 years, mean±SE 39.9±16.5) with untreated Graves' disease were included in the study. Methimazole or propylthiouracil was given to all of the patients. Biochemical markers (serum N-mid osteocalcin (OCN-mid), alkaline phosphatase (ALP), type I collagen C-terminal telopeptide (sCTx), urinary pyridinoline (Pyr), deoxypyridinoline (Dpyr) and type I collagen C-terminal telopeptide (uCTx) and bone mineral density at the distal one third of the radius were assessed prior to treatment, and in the first, third, sixth and twelfth months of treatment.Results: All biochemical markers had increased significantly 12 months after treatment compared with the baseline values (OCN-mid, p<0.05; ALP, p<0.01; sCTx, p<0.05; Pyr, Dpyr, uCTx, p<0.01). Among the biochemical markers, urinary Pyr and Dpyr had decreased the most prominently 12 months after treatment. However, BMD at the distal one third of the radius did not improve after 12 months of treatment.Conclusion: Based on assessments of BMD at the distal one third of the radius, one year is not enough to restore bone mass using antithyroid drug therapy in patients with Graves' disease.