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A prospective study of thyroid function, bone loss, and fractures in older men: The MrOS study.
J Bone Miner Res 2013; 28(3):472-9JB

Abstract

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 65 years and older. Using a case-cohort design, fasting baseline serum archived at -80°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 4.6 years. 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], 0.74-1.14), but was significantly associated with risk of hip fracture (RH 1.31; 95% CI, 1.01-1.71), which persisted among normal range TSH values (RH 1.21; 95% CI, 1.00-1.47). 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.

Authors+Show Affiliations

Division of Endocrinology and Metabolism, University of California, San Francisco, San Francisco, CA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

23018684

Citation

Waring, Avantika C., et al. "A Prospective Study of Thyroid Function, Bone Loss, and Fractures in Older Men: the MrOS Study." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 28, no. 3, 2013, pp. 472-9.
Waring AC, Harrison S, Fink HA, et al. A prospective study of thyroid function, bone loss, and fractures in older men: The MrOS study. J Bone Miner Res. 2013;28(3):472-9.
Waring, A. C., Harrison, S., Fink, H. A., Samuels, M. H., Cawthon, P. M., Zmuda, J. M., ... Bauer, D. C. (2013). A prospective study of thyroid function, bone loss, and fractures in older men: The MrOS study. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 28(3), pp. 472-9. doi:10.1002/jbmr.1774.
Waring AC, et al. A Prospective Study of Thyroid Function, Bone Loss, and Fractures in Older Men: the MrOS Study. J Bone Miner Res. 2013;28(3):472-9. PubMed PMID: 23018684.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A prospective study of thyroid function, bone loss, and fractures in older men: The MrOS study. AU - Waring,Avantika C, AU - Harrison,Stephanie, AU - Fink,Howard A, AU - Samuels,Mary H, AU - Cawthon,Peggy M, AU - Zmuda,Joseph M, AU - Orwoll,Eric S, AU - Bauer,Douglas C, AU - ,, PY - 2012/07/02/received PY - 2012/09/07/revised PY - 2012/09/14/accepted PY - 2012/9/29/entrez PY - 2012/9/29/pubmed PY - 2013/8/30/medline SP - 472 EP - 9 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J. Bone Miner. Res. VL - 28 IS - 3 N2 - 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 65 years and older. Using a case-cohort design, fasting baseline serum archived at -80°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 4.6 years. 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], 0.74-1.14), but was significantly associated with risk of hip fracture (RH 1.31; 95% CI, 1.01-1.71), which persisted among normal range TSH values (RH 1.21; 95% CI, 1.00-1.47). 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. SN - 1523-4681 UR - https://www.unboundmedicine.com/medline/citation/23018684/A_prospective_study_of_thyroid_function_bone_loss_and_fractures_in_older_men:_The_MrOS_study_ L2 - https://doi.org/10.1002/jbmr.1774 DB - PRIME DP - Unbound Medicine ER -