Bone geometry in older adults with subclinical hypothyroidism upon levothyroxine therapy: A nested study within a randomized placebo controlled trial.

Details

Serval ID
serval:BIB_A9D4E89092B7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Bone geometry in older adults with subclinical hypothyroidism upon levothyroxine therapy: A nested study within a randomized placebo controlled trial.
Journal
Bone
Author(s)
Büchi A.E., Feller M., Netzer S., Blum M.R., Gonzalez Rodriguez E., Collet T.H., Del Giovane C., van Heemst D., Quinn T., Kearney P.M., Westendorp RGJ, Gussekloo J., Mooijaart S.P., Hans D., Bauer D.C., Rodondi N., Aeberli D.
ISSN
1873-2763 (Electronic)
ISSN-L
1873-2763
Publication state
Published
Issued date
08/2022
Peer-reviewed
Oui
Volume
161
Pages
116404
Language
english
Notes
Publication types: Journal Article ; Randomized Controlled Trial
Publication Status: ppublish
Abstract
The effect of levothyroxine (LT4) therapy for subclinical hypothyroidism (SHypo) on appendicular bone geometry and volumetric density has so far not been studied. In a nested study within the randomized, placebo-controlled Thyroid Hormone Replacement for Subclinical Hypothyroidism (TRUST) trial, we assessed the effect of LT4 therapy on bone geometry as measured by peripheral quantitative computed tomography (pQCT). In the TRUST trial, community-dwelling adults aged ≥65 years with SHypo were randomized to LT4 with dose titration vs. placebo with mock titration. We analyzed data from participants enrolled at the TRUST site in Bern, Switzerland who had bone pQCT measured at baseline and at 1 to 2 years follow-up. The primary outcomes were the annual percentage changes of radius and tibia epi- and diaphysis bone geometry (total and cortical cross-sectional area (CSA) and cortical thickness), and of volumetric bone mineral density (bone mineral content (BMC) and total, trabecular and cortical volumetric bone mineral density (vBMD)). We performed linear regression of the annual percentage changes adjusted for sex, LT4 dose at randomization and muscle cross-sectional area. The 98 included participants had a mean age of 73.9 (±SD 5.4) years, 45.9% were women, and 12% had osteoporosis. They were randomized to placebo (n = 48) or LT4 (n = 50). Annual changes in BMC and vBMD were similar between placebo and LT4-treated groups, without significant difference in bone geometry or volumetric bone mineral density changes, neither at the diaphysis, nor at the epiphysis. For example, in the placebo group, epiphyseal BMC (radius) decreased by a mean 0.2% per year, with a similar decrease of 0.5% per year in the LT4 group (between-group difference in %ΔBMC 0.3, 95% CI -0.70 to 1.21, p = 0.91). Compared to placebo, LT4 therapy for an average 14 months had no significant effect on bone mass, bone geometry and volumetric density in older adults with subclinical hypothyroidism. TRIAL REGISTRATION: The trial was registered on ClinicalTrials.gov numbers NCT01660126 (TRUST Thyroid trial) and NCT02491008 (Skeletal outcomes).
Keywords
Aged, Bone Density/physiology, Bone and Bones, Female, Humans, Hypothyroidism/drug therapy, Male, Radius/physiology, Thyroxine/pharmacology, Thyroxine/therapeutic use, Tibia, Bone geometry, Levothyroxine, Peripheral quantitative computational tomography, Subclinical hypothyoroidism, Volumetric bone density
Pubmed
Web of science
Open Access
Yes
Create date
11/04/2022 8:13
Last modification date
19/06/2022 6:37
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