A Causality between Thyroid Function and Bone Mineral Density in Childhood: Abnormal Thyrotropin May Be Another Pediatric Predictor of Bone Fragility
Abstract
:1. Introduction
2. Methods
2.1. Participants
2.2. Disease Category
2.2.1. Hemato-Oncologic Disease
2.2.2. Rheumatoid Disease
2.2.3. Gastrointestinal Disease
2.2.4. Endocrine Disease
2.3. Data Collection
2.3.1. Anthropometric Measurement
2.3.2. BMD Assessment
2.3.3. Thyroid Function Test
2.4. Statistical Analysis
3. Results
3.1. Demographic and Clinical Characteristics
3.2. LSBMD and Thyroid Function of Patients with an Underlying Condition
3.3. BMD Status under Abnormal Thyroid Function
3.4. Causal Association between BMD and Thyroid Function
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Total (n = 619) | |
---|---|
Male, n (%) | 312 (50.9) |
Age, y | 13.22 ± 3.23 |
Anthropometry, z-score | |
Height | −0.51 ± 1.27 |
Weight | −0.22 ± 1.48 |
Body mass index | 0.03 ± 1.52 |
Underlying condition, n (%) | |
Hemato-oncologic | 493 (79.6) |
Rheumatoid | 64 (10.3) |
Gastrointestinal | 23 (3.7) |
Endocrinologic | 19 (3.1) |
Miscellaneous | 20 (3.2) |
Age at diagnosis, years | 9.26 ± 11.86 |
Bone mineral density | |
Lumbar spine, g/cm2 | 0.81 ± 0.19 |
Lumbar spine, z-score | 0.49 ± 1.28 |
Low bone mass, n (%) | |
≤0 | 432 (70.5) |
≤−1.0 | 231 (37.7) |
≤−2.0 | 72 (11.7) |
≤−3.0 | 18 (2.9) |
Right femur, g/cm2 | 0.76 ± 0.16 |
Right femur, z-score | −1.04 ± 1.32 |
Left femur, g/cm2 | 0.77 ± 0.16 |
Left femur, z-score | −1.03 ± 1.34 |
Thyroid function | |
T3, ng/mL | 1.25 ± 0.29 |
Interpretation, n (%) | |
Normal | 505 (92.7) |
Low | 39 (7.2) |
High | 1 (0.2) |
FT4, ng/dL | 1.28 ± 0.19 |
Interpretation, n (%) | |
Normal | 614 (99.5) |
Low | 3 (0.5) |
High | 0 (0) |
TSH, µU/mL | 2.76 ± 1.87 |
Interpretation, n (%) | |
Normal | 560 (90.5) |
Low | 36 (5.8) |
High | 23 (3.7) |
z-Scores | T3 | FT4 | TSH | ||||||
---|---|---|---|---|---|---|---|---|---|
Normal | Abnormal | p | Normal | Abnormal | p | Normal | Abnormal | p | |
LSBMD | −0.47 ± 1.26 | −0.67 ± 1.4 | 0.357 | −0.48 ± 1.28 | −1.23 ± 1.53 | 0.31 | −0.45 ± 1.25 | −0.86±1.46 | 0.018 |
RFBMD | −1.03 ± 1.28 | −1.17 ± 1.7 | 0.537 | −1.04 ± 1.33 | −0.8 ± 1.4 | 0.75 | −1.01 ± 1.32 | −1.39±1.35 | 0.036 |
LFBMD | −1.01 ± 1.3 | −1.31 ± 1.73 | 0.211 | −1.03 ± 1.34 | −1.0 ± 1.56 | 0.969 | −0.98 ± 1.32 | −1.49±1.48 | 0.007 |
Clinical Parameter | Univariate | Multivariate | ||||
---|---|---|---|---|---|---|
β (95% CI) | SE | p | β (95% CI) | SE | p | |
Underlying condition | ||||||
Hemato-oncologic | −0.15 (−0.18–0.49) | 0.17 | 0.371 | 0.18 (−0.15–0.51) | 0.17 | 0.291 |
Rheumatoid | −0.27 (−0.81–0.27) | 0.27 | 0.324 | 0.27 (−0.31–0.86) | 0.29 | 0.359 |
Gastrointestinal | −0.22 (−0.81–0.36) | 0.29 | 0.455 | 0.13 (−0.57–0.84) | 0.36 | 0.709 |
Endocrinologic | 0.04 (−0.54–0.61) | 0.29 | 0.9 | 0.29 (−0.29–0.87) | 0.29 | 0.322 |
† Height | 0.42 (0.35–0.49) | 0.04 | <0.001 | |||
† Weight | 0.41 (0.35–0.47) | 0.03 | <0.001 | |||
† BMI | 0.31 (0.25–0.37) | 0.03 | <0.001 | 0.32 (0.26–0.39) | 0.03 | <0.001 |
† RFBMD | 0.73 (0.68–0.78) | 0.03 | <0.001 | |||
† LFBMD | 0.74 (0.69–0.79) | 0.03 | <0.001 | |||
T3 | 0.19 (−0.17–0.55) | 0.18 | 0.302 | −0.06 (−0.41–0.29) | 0.18 | 0.749 |
FT4 | −0.04 (−0.55–0.48) | 0.26 | 0.889 | −0.05 (−0.44–0.55) | 0.25 | 0.833 |
TSH | 0.02 (−0.03–0.07) | 0.03 | 0.455 | 0.01 (−0.04–0.07) | 0.03 | 0.637 |
Clinical Parameter | LSBMD z-Score ≤ −1.0 | LSBMD z-Score ≤ −2.0 | LSBMD z-Score ≤ −3.0 | ||||||
---|---|---|---|---|---|---|---|---|---|
OR (95% CI) | SE | p | OR (95% CI) | SE | p | OR (95% CI) | SE | p | |
Abnormal T3 | |||||||||
Unadjusted | 1.02 (0.53–1.98) | 0.34 | 0.953 | 2.38 (1.07–5.25) | 0.41 | 0.033 | 0.97 (0.12–7.61) | 1.05 | 0.977 |
† Adjusted | 0.93 (0.43–2.01) | 0.39 | 0.931 | 2.29 (0.92–5.69) | 0.47 | 0.075 | 1.05 (0.11–10.36) | 0.04 | 0.968 |
Abnormal FT4 | |||||||||
Unadjusted | 3.39 (0.31–37.55) | 1.23 | 0.32 | 3.82 (0.34–42.71) | 1.23 | 0.276 | <0.01 (<0.01–0.01) | 1385.38 | 0.992 |
† Adjusted | 1.81 (0.14–23.24) | 1.3 | 0.649 | 2.43 (0.18–32.13) | 1.32 | 0.499 | <0.01 (<0.01–0.01) | <0.01 | 0.996 |
Abnormal TSH | |||||||||
Unadjusted | 1.85 (1.08–3.17) | 0.27 | 0.026 | 2.4 (1.23–4.7) | 0.34 | 0.011 | 3.89 (1.34–11.34) | 0.55 | 0.013 |
† Adjusted | 2.25 (1.24–4.08) | 0.3 | 0.008 | 2.65 (1.29–5.46) | 0.37 | 0.008 | 6.21 (1.8–21.41) | 2.89 | 0.004 |
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Lee, D.; Ahn, M.B. A Causality between Thyroid Function and Bone Mineral Density in Childhood: Abnormal Thyrotropin May Be Another Pediatric Predictor of Bone Fragility. Metabolites 2023, 13, 372. https://doi.org/10.3390/metabo13030372
Lee D, Ahn MB. A Causality between Thyroid Function and Bone Mineral Density in Childhood: Abnormal Thyrotropin May Be Another Pediatric Predictor of Bone Fragility. Metabolites. 2023; 13(3):372. https://doi.org/10.3390/metabo13030372
Chicago/Turabian StyleLee, Dongjin, and Moon Bae Ahn. 2023. "A Causality between Thyroid Function and Bone Mineral Density in Childhood: Abnormal Thyrotropin May Be Another Pediatric Predictor of Bone Fragility" Metabolites 13, no. 3: 372. https://doi.org/10.3390/metabo13030372