Jie Liu, Yanying Li, Jifang Liu, Zhang Ye, He Liu, Xiaofeng Chai, Huijuan Zhu, Bing Xing, Wei Lian, Xiaolan Lian, Naishi Li, Lin Lu, Mei Zhang, Lian Duan, Yong Yao, Kan Deng
{"title":"垂体tsh分泌腺瘤骨密度损害：一项回顾性对照研究。","authors":"Jie Liu, Yanying Li, Jifang Liu, Zhang Ye, He Liu, Xiaofeng Chai, Huijuan Zhu, Bing Xing, Wei Lian, Xiaolan Lian, Naishi Li, Lin Lu, Mei Zhang, Lian Duan, Yong Yao, Kan Deng","doi":"10.1016/j.eprac.2025.09.202","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Hyperthyroidism can harm bone health, though it is seldom reported in TSHomas. This study assessed bone mineral density (BMD) and bone turnover markers (BTM) in TSHoma patients versus euthyroid controls and evaluated the impact of surgical treatment on bone metabolism.</p><p><strong>Methods: </strong>We retrospectively reviewed 85 TSHoma patients who underwent BMD tests. Of these, 71 had baseline BMD data and were matched with 71 euthyroid healthy controls by age, sex, and BMI. BMD and BTMs were measured.</p><p><strong>Results: </strong>TSHoma patients demonstrated significantly reduced BMD compared to matched euthyroid controls across all skeletal sites, with reductions of 12.4% at the lumbar spine (1.06±0.19 vs. 1.21±0.14 g/cm<sup>2</sup>, p < 0.001), 8.5% at the femoral neck (0.86±0.14 vs. 0.94±0.11 g/cm<sup>2</sup>, p < 0.001), and 14.8% at the total hip (0.86±0.13 vs. 1.01±0.12 g/cm<sup>2</sup>, p < 0.001). Baseline BTMs revealed elevated osteoblastic [P1NP 108 (60, 202) ng/mL] and osteoclastic markers [β-CTX 0.84 (0.62, 1.30) ng/mL]. Besides, FT3 showed strong positive correlations with BTMs: ALP (r = 0.45, p = 0.005), β-CTX (r = 0.61, p < 0.001), and P1NP (r = 0.73, p = 0.004).Following tumor resection, BTMs decreased significantly: ALP [91 (74.25, 119.5) to 71 (68, 94) U/L, p = 0.003] and β-CTX [0.75 (0.57, 0.94) to 0.22 (0.21, 0.45) ng/mL, p = 0.008]. Postoperative BMD revealed stabilization with non-significant improvements at all measured skeletal sites.</p><p><strong>Conclusions: </strong>TSHoma patients exhibit significant BMD deficits compared to euthyroid controls. Surgery effectively reduces BTMs while stabilizing BMD, preventing further deterioration rather than resoring bone density.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":4.6000,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impairment of Bone Mineral Density in Pituitary TSH-secreting adenomas: A Retrospective, Controlled study.\",\"authors\":\"Jie Liu, Yanying Li, Jifang Liu, Zhang Ye, He Liu, Xiaofeng Chai, Huijuan Zhu, Bing Xing, Wei Lian, Xiaolan Lian, Naishi Li, Lin Lu, Mei Zhang, Lian Duan, Yong Yao, Kan Deng\",\"doi\":\"10.1016/j.eprac.2025.09.202\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Hyperthyroidism can harm bone health, though it is seldom reported in TSHomas. This study assessed bone mineral density (BMD) and bone turnover markers (BTM) in TSHoma patients versus euthyroid controls and evaluated the impact of surgical treatment on bone metabolism.</p><p><strong>Methods: </strong>We retrospectively reviewed 85 TSHoma patients who underwent BMD tests. Of these, 71 had baseline BMD data and were matched with 71 euthyroid healthy controls by age, sex, and BMI. BMD and BTMs were measured.</p><p><strong>Results: </strong>TSHoma patients demonstrated significantly reduced BMD compared to matched euthyroid controls across all skeletal sites, with reductions of 12.4% at the lumbar spine (1.06±0.19 vs. 1.21±0.14 g/cm<sup>2</sup>, p < 0.001), 8.5% at the femoral neck (0.86±0.14 vs. 0.94±0.11 g/cm<sup>2</sup>, p < 0.001), and 14.8% at the total hip (0.86±0.13 vs. 1.01±0.12 g/cm<sup>2</sup>, p < 0.001). Baseline BTMs revealed elevated osteoblastic [P1NP 108 (60, 202) ng/mL] and osteoclastic markers [β-CTX 0.84 (0.62, 1.30) ng/mL]. Besides, FT3 showed strong positive correlations with BTMs: ALP (r = 0.45, p = 0.005), β-CTX (r = 0.61, p < 0.001), and P1NP (r = 0.73, p = 0.004).Following tumor resection, BTMs decreased significantly: ALP [91 (74.25, 119.5) to 71 (68, 94) U/L, p = 0.003] and β-CTX [0.75 (0.57, 0.94) to 0.22 (0.21, 0.45) ng/mL, p = 0.008]. Postoperative BMD revealed stabilization with non-significant improvements at all measured skeletal sites.</p><p><strong>Conclusions: </strong>TSHoma patients exhibit significant BMD deficits compared to euthyroid controls. 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引用次数: 0
摘要
目的：甲状腺机能亢进对骨健康有危害，但在tshoma中很少报道。本研究评估了TSHoma患者与正常甲状腺对照者的骨密度（BMD）和骨转换标志物（BTM），并评估了手术治疗对骨代谢的影响。方法：我们回顾性分析了85例接受BMD检查的TSHoma患者。其中，71人有基线BMD数据，并与71名甲状腺功能正常的健康对照者按年龄、性别和BMI进行匹配。测量BMD和btm。结果：与匹配的甲状腺正常对照组相比，TSHoma患者在所有骨骼部位的骨密度均显著降低，腰椎降低12.4%(1.06±0.19比1.21±0.14 g/cm2, p < 0.001)，股骨颈降低8.5%(0.86±0.14比0.94±0.11 g/cm2, p < 0.001)，全髋关节降低14.8%（0.86±0.13比1.01±0.12 g/cm2, p < 0.001）。基线BTMs显示成骨细胞[P1NP 108 (60,202) ng/mL]和破骨细胞标志物[β-CTX 0.84 (0.62, 1.30) ng/mL]升高。FT3与BTMs呈显著正相关：ALP （r = 0.45, p = 0.005）、β-CTX （r = 0.61, p < 0.001）、P1NP （r = 0.73, p = 0.004）。肿瘤切除后，BTMs显著降低：ALP[91（74.25, 119.5）至71 (68,94)U/L, p = 0.003], β-CTX[0.75（0.57, 0.94）至0.22 (0.21,0.45)ng/mL, p = 0.008]。术后骨密度显示稳定，所有测量的骨骼部位均无明显改善。结论：与甲状腺功能正常的对照组相比，TSHoma患者表现出明显的BMD缺陷。手术有效地减少脑转移，同时稳定骨密度，防止进一步恶化，而不是恢复骨密度。
Impairment of Bone Mineral Density in Pituitary TSH-secreting adenomas: A Retrospective, Controlled study.
Objective: Hyperthyroidism can harm bone health, though it is seldom reported in TSHomas. This study assessed bone mineral density (BMD) and bone turnover markers (BTM) in TSHoma patients versus euthyroid controls and evaluated the impact of surgical treatment on bone metabolism.
Methods: We retrospectively reviewed 85 TSHoma patients who underwent BMD tests. Of these, 71 had baseline BMD data and were matched with 71 euthyroid healthy controls by age, sex, and BMI. BMD and BTMs were measured.
Results: TSHoma patients demonstrated significantly reduced BMD compared to matched euthyroid controls across all skeletal sites, with reductions of 12.4% at the lumbar spine (1.06±0.19 vs. 1.21±0.14 g/cm2, p < 0.001), 8.5% at the femoral neck (0.86±0.14 vs. 0.94±0.11 g/cm2, p < 0.001), and 14.8% at the total hip (0.86±0.13 vs. 1.01±0.12 g/cm2, p < 0.001). Baseline BTMs revealed elevated osteoblastic [P1NP 108 (60, 202) ng/mL] and osteoclastic markers [β-CTX 0.84 (0.62, 1.30) ng/mL]. Besides, FT3 showed strong positive correlations with BTMs: ALP (r = 0.45, p = 0.005), β-CTX (r = 0.61, p < 0.001), and P1NP (r = 0.73, p = 0.004).Following tumor resection, BTMs decreased significantly: ALP [91 (74.25, 119.5) to 71 (68, 94) U/L, p = 0.003] and β-CTX [0.75 (0.57, 0.94) to 0.22 (0.21, 0.45) ng/mL, p = 0.008]. Postoperative BMD revealed stabilization with non-significant improvements at all measured skeletal sites.
Conclusions: TSHoma patients exhibit significant BMD deficits compared to euthyroid controls. Surgery effectively reduces BTMs while stabilizing BMD, preventing further deterioration rather than resoring bone density.
期刊介绍：
Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.
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