Longitudinal Changes in Bone Mineral Density and Trabecular Bone Score in Adolescents With Graves' Disease.

IF 2.4 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Clinical Endocrinology Pub Date : 2025-07-21 DOI:10.1111/cen.70004

Pattara Wiromrat, Nantaporn Wongsurawat, Ratikorn Chaisiwamongkol, Yutapong Raruenrom, Piyanan Suparattanagool, Ouyporn Panamonta, Chatlert Pongchaiyakul

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引用次数: 0

Abstract

Objective: Longitudinal data on bone health in adolescents with Graves' disease (GD) are limited. Thus, we aimed to evaluate lumbar spine bone mineral density (LSBMD) and trabecular bone score (TBS) changes in this population.

Methods: Baseline and follow-up LSBMD Z-score (LSBMD_Z) and TBS Z-score (TBS_Z) were measured. TBS was analysed using iNsight software.

Results: Forty-one adolescents with GD (age 13.7 ± 2.8 years, 73% female) were enroled. At baseline, 18% of adolescents with recently diagnosed GD (RGD, ≤ 6 months) had low LSBMD (median LSBMD_Z: -0.7 [-1.5 to -0.4]), and 58% had low TBS (mean TBS_Z: -1.5 ± 1.3). The median follow-up duration was 2.2 (1.2-2.9) years. In the entire cohort, at follow-up, LSBMD_Z normalized, whereas TBS_Z remained below zero (p = 0.007). Adolescents with RGD and those with longer disease duration had comparable LSBMD_Z and TBS_Z at follow-up. When stratified by baseline disease duration tertiles, improvements in LSBMD_Z (p = 0.013) and TBS_Z (p = 0.035) progressively declined with increasing disease duration. LSBMD_Z was significantly increased from baseline during 28 months of treatment (p = 0.01), while TBS_Z improvement was observed during the initial 9 months (p = 0.046). Stepwise regression identified time-weighted free thyroxine (FT4) as a negative predictor of ∆TBS_Z (p = 0.042).

Conclusions: Low TBS was prevalent among adolescents recently diagnosed with GD. Despite observed improvements, TBS_Z remained below zero at follow-up, indicating incomplete recovery. As FT4 negatively impacts TBS improvement, maintaining optimal FT4 concentrations early in the disease is crucial for preserving bone microarchitecture in paediatric GD.

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青少年Graves病骨密度和骨小梁评分的纵向变化。

目的：Graves病（GD）青少年骨健康的纵向资料有限。因此，我们旨在评估这一人群的腰椎骨矿物质密度（LSBMD）和骨小梁评分（TBS）的变化。方法：测量基线和随访时的LSBMD Z-score （LSBMDZ）和TBS Z-score （TBSZ）。采用iNsight软件对TBS进行分析。结果：纳入41例青少年GD患者（年龄13.7±2.8岁，73%为女性）。在基线时，18%的新近诊断为GD的青少年（RGD，≤6个月）有低LSBMD（中位lsbmz: -0.7[-1.5至-0.4]），58%的青少年有低TBS（平均TBSZ: -1.5±1.3）。中位随访时间为2.2（1.2-2.9）年。在整个队列中，随访时，LSBMDZ正常化，而TBSZ仍低于零（p = 0.007）。随访时，患有RGD的青少年和病程较长的青少年的LSBMDZ和TBSZ相当。当按基线病程分位数分层时，随着病程的增加，LSBMDZ （p = 0.013）和TBSZ （p = 0.035）的改善逐渐下降。治疗28个月后，LSBMDZ较基线显著升高（p = 0.01），而TBSZ在治疗前9个月改善（p = 0.046）。逐步回归发现时间加权游离甲状腺素（FT4）是∆TBSZ的负预测因子（p = 0.042）。结论：低TBS在新近诊断为GD的青少年中普遍存在。尽管观察到改善，TBSZ在随访时仍低于零，表明恢复不完全。由于FT4对TBS的改善有负面影响，因此在疾病早期维持最佳FT4浓度对于保存儿科GD患者的骨微结构至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Endocrinology 医学-内分泌学与代谢

CiteScore

6.40

自引率

3.10%

发文量

192

审稿时长

1 months

期刊介绍： Clinical Endocrinology publishes papers and reviews which focus on the clinical aspects of endocrinology, including the clinical application of molecular endocrinology. It does not publish papers relating directly to diabetes care and clinical management. It features reviews, original papers, commentaries, correspondence and Clinical Questions. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.