Journal
JOURNAL OF BONE AND MINERAL RESEARCH
Volume 28, Issue 3, Pages 472-479Publisher
WILEY
DOI: 10.1002/jbmr.1774
Keywords
THYROID FUNCTION; OSTEOPOROSIS; MEN; BONE DENSITY; FRACTURE
Categories
Funding
- National Institutes of Health (NIH)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
- National Institute on Aging (NIA)
- National Center for Research Resources (NCRR)
- NIH Roadmap for Medical Research [U01 AR45580, U01 AR45614, U01 AR45632, U01 AR45647, U01 AR45654, U01 AR45583, U01 AG18197, U01-AG027810, UL1 RR024140]
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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 65years and older. Using a case-cohort design, fasting baseline serum archived at 80 degrees 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 4.6years. 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], 0.741.14), but was significantly associated with risk of hip fracture (RH 1.31; 95% CI, 1.011.71), which persisted among normal range TSH values (RH 1.21; 95% CI, 1.001.47). 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. (c) 2013 American Society for Bone and Mineral Research.
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