Ankara Med J. 2020; 20(2): 407-415 | DOI: 10.5505/amj.2020.56933

Postmenopozal Kadýnlarda Subklinik Tiroid Hastalýðý Sýklýðýnýn ve Kemik Mineral Yoðunluðu ile Ýliþkisinin Deðerlendirilmesi

Çaðlar Keskin¹, Esra Nur Ademoðlu Dilekçi¹, Müge Keskin^2
1Bolu Abant Ýzzet Baysal Üniversitesi Týp Fakültesi, Endokrinoloji Ve Metabolizma Hastalýklarý Bilim Dalý, Bolu
²Ankara Þehir Hastanesi, Endokrinoloji Ve Metabolizma Hastalýklarý Kliniði

GÝRÝÞ ve AMAÇ: Bu çalýþmada postmenopozal kadýnlarda subklinik tiroid disfonksiyonu sýklýðýnýn deðerlendirilmesi ve subklinik tiroid disfonksiyonu ile kemik mineral yoðunluðu (KMY) iliþkisinin araþtýrýlmasý amaçlandý.
YÖNTEM ve GEREÇLER: Çalýþmaya Bolu Abant Ýzzet Baysal Üniversitesi Týp Fakültesi Endokrinoloji ve Metabolizma Hastalýklarý Polikliniði’nde Ocak 2018-Aralýk 2019 tarihleri arasýnda osteoporoz ön tanýsý ile deðerlendirilen 300 postmenopozal kadýn dahil edildi. Tüm katýlýmcýlarýn demografik verileri, tiroid stimüle edici hormon (TSH), serbest triiyodotironin (ST3), serbest tiroksin (ST4) düzeyleri, kemik mineral yoðunluðu (KMY) sonuçlarý hastane kayýt sisteminden retrospektif olarak kaydedildi. Tüm katýlýmcýlar ötiroid, subklinik hipertiroidi ve subklinik hipotiroidi olmak üzere 3 gruba ayrýldý. Ötiroid grup ayrýca TSH düzeylerine göre yüksek normal ve düþük normal olmak üzere 2 gruba ayrýldý. Subklinik tiroid disfonksiyonu subklinik hipertiroidi ve subklinik hipotiroidi olarak tanýmlandý. Aþikar hipotiroidi veya hipertiroidisi olan bireyler çalýþma dýþý býrakýldý.
BULGULAR: Bu çalýþmada postmenopozal kadýnlarýn %10.66’sýnda subklinik tiroid disfonksiyonu tespit edildi [subklinik hipertiroidi: 21(%7); subklinik hipotiroidi: 11 (%3.66)]. Subklinik tiroid fonksiyon bozukluðu olan bireylerde lomber vertebra (L1-4) ve femur kemik mineral yoðunluklarýnda ötiroid gruba göre istatistiksel olarak anlamlý bir farklýlýk saptanmadý (sýrasýyla; p=0.674 ve p= 0.184). Ötiroid grupta yüksek normal TSH düzeyleri ve düþük normal TSH düzeylerine sahip subgruplar arasýnda osteoporoz sýklýðý, vertebra (L1-4) ve femur kemik mineral yoðunluklarý benzerdi (sýrasýyla; p=0.935, p=0.850, p=0.734).
TARTIÞMA ve SONUÇ: Bu çalýþmada postmenopozal kadýnlarda subklinik tiroid disfonksiyonlarý ile KMY ölçümleri arasýnda istatiksel olarak anlamlý bir iliþki bulunmadý.

Anahtar Kelimeler: Kemik mineral yoðunluðu, osteoporoz, subklinik tiroid disfonksiyonu

---

Evaluation of the Frequency of Subclinical Thyroid Disease in Postmenopausal Women and its Relationship with Bone Mineral Density

Çaðlar Keskin¹, Esra Nur Ademoðlu Dilekçi¹, Müge Keskin^2
1Department Of Endocrinology And Metabolic Diseases, Bolu Abant Ýzzet Baysal University, Bolu
²Department Of Endocrinology And Metabolic Diseases, Ankara City Hospital, Ankara

INTRODUCTION: The purpose of this study was to evaluate the frequency of subclinical thyroid dysfunction and the relationship between subclinical thyroid dysfunction and bone mineral density (BMD) in postmenopausal women.
METHODS: 300 postmenopausal women screened for osteoporosis between January 2018 and December 2019 in Bolu Abant Izzet Baysal University Faculty of Medicine, Department of Endocrinology and Metabolic Diseases were included in the study. Demographic data, thyroid -stimulating hormone (TSH), free triiodothyronine (fT3) and free thyroxine (fT4) levels and bone mineral densitometry (BMD) measurements of all participants were recorded retrospectively from the hospital registry system. All participants were divided into 3 groups as euthyroid, subclinical hyperthyroidism and subclinical hypothyroidism. The euthyroid group was also divided into two groups, those with high normal TSH and low normal TSH. Subclinical thyroid dysfunction was defined as subclinical hyperthyroidism and subclinical hypothyroidism. Individuals with overt hypothyroidism or hyperthyroidism were excluded from the study.
RESULTS: Subclinical thyroid dysfunction was detected in 10.66% of postmenopausal women [subclinical hyperthyroidism: 21 (7%); subclinical hypothyroidism: 11 (3.66%)]. No statistically significant difference was found in subjects with subclinical thyroid dysfunction in terms of vertebral (L1-4) and femoral bone mineral density compared to the euthyroid group. (p=0.67 and p= 0.18; respectively). Among the subgroups with high normal TSH levels and low normal TSH levels in the euthyroid group, the frequency of osteoporosis, vertebral (L1-4) and femoral BMD measurments were similar (p=0.93, p=0.85, p=0.73, respectively).
DISCUSSION AND CONCLUSION: We found no significant associations between subclinical thyroid dysfunctions and BMD in postmenopausal women.

Keywords: Bone mineral density, osteoporosis, subclinical thyroid dysfunction

---

ATIF KOPYALA