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Trabecular Bone Score and Bone Deterioration Risk in Differentiated Thyroid Cancer

By: Joshua D. Madera, MS
Posted: Wednesday, August 26, 2020

For patients with differentiated thyroid cancer, the trabecular bone score may serve as an indicative measure of patients at risk for bone deterioration, according to a study published in Cancer Medicine. “We found deterioration of trabecular structure in patients with differentiated thyroid cancer and thyroid-stimulating hormone suppression therapy below 0.1 µU/mL and after 5 to 10 years of follow‐up,” reported Guillermo Martínez Díaz-Guerra, MD, of the University Hospital 12 de Octubre, Madrid, Spain, and colleagues.

A total of 145 women with resected differentiated thyroid cancer who received long-term thyroid-stimulating hormone (TSH) therapy were enrolled in the study. Most of the patients (n= 131) were postmenopausal. Patients were grouped based on the degree of TSH suppression: group 1 was suppressed between 5 and 10 years, and group 2 was suppressed for more than 10 years. Via use of dual-energy x-ray absorptiometry and medical imaging software, trabecular bone score and bone mineral density were evaluated at baseline and the final visit.

The investigators reported increased TSH levels from baseline for both patient groups. However, patients who had more than 10 years of TSH suppression demonstrated decreased bone mineral density in their lumbar spine and femoral neck regions. In addition, as compared with baseline, the total trabecular bone score was reduced in both groups. Patients with a TSH value below 0.1 µU/mL demonstrated decreased trabecular bone scores (P = .0086). However, trabecular bone scores were not significantly decreased in patients with TSH values between 0.1 and 0.5 µU/mL or higher.

Use of the trabecular bone score in patients with differentiated thyroid cancer may prove to be a useful technique for assessing patients for skeletal fragility and potential fracture risk, the authors concluded.

Disclosure: For full disclosures of the study authors, visit onlinelibrary.wiley.com.

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