Changes in bone mineral density, 25‑hydroxyvitamin D3 and inflammatory factors in patients with hyperthyroidism

Zhou,Yali; Wang,Xixia; Xin,Maoyuan; Zhuang,Haiting

doi:10.3892/etm.2021.10049

Changes in bone mineral density, 25‑hydroxyvitamin D3 and inflammatory factors in patients with hyperthyroidism

Authors:
- Yali Zhou
- Xixia Wang
- Maoyuan Xin
- Haiting Zhuang
View Affiliations

Affiliations: Department of Traumatic Orthopaedics, Weifang People's Hospital, Weifang, Shandong 261000, P.R. China, Department of Internal Medicine, Zhucheng BaiChiHe Hospital, Zhucheng, Shandong 262217, P.R. China, Department of Anesthesiology, Weifang People's Hospital, Weifang, Shandong 261000, P.R. China
Published online on: April 14, 2021 https://doi.org/10.3892/etm.2021.10049
Article Number: 617

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The present study aimed to evaluate changes in bone mineral density, 25‑hydroxyvitamin D₃ [25‑(OH)D₃] and inflammatory factors in patients with hyperthyroidism, in order to determine the correlations with the pathogenesis of hyperthyroidism. A total of 55 patients with hyperthyroidism (observation group) and 53 healthy patients (control group) enrolled at Weifang People's Hospital from March 2017 to February 2018 were randomly enrolled. The thyroid function, bone mineral density, 25‑(OH)D₃ and inflammatory factors were measured and compared between the two groups. The measurement data are presented as mean ± standard deviation (SD), and Student t‑test was performed for the comparison between two groups. Chi‑square test was used for enumeration data regarding sex. Pearson correlation analysis was performed for two‑variable analysis on L1, 25‑(OH)D₃, interleukin (IL)‑2, IL‑6 with FT3, respectively. In regards to the results, no difference in sex, age and body mass index (BMI) between the two groups were found but the thyroid function was markedly enhanced in the observation group compared to the control group. Bone mineral density index and 25‑(OH)D₃ in the observation group were significantly lower than those in the control group (P<0.05). There were significant differences in the inflammatory factors between the two groups (P<0.05). The L1, 25‑(OH)D₃ and IL‑2 levels were significantly negatively correlated with thyroid function index and free triiodothyronine (FT3) while a statistically positive correlation was found between IL‑6 and FT3 (P<0.05). In conclusion, abnormal levels of bone mineral density, 25‑(OH)D₃ and inflammatory factors are observed in patients with hyperthyroidism, and there are correlations between L1, 25‑(OH)D₃, IL‑2, IL‑6 and FT3 in the pathogenesis of hyperthyroidism, which provides new insight for the diagnosis of hyperthyroidism.

View Figures

View References

1	De Leo S, Lee SY and Braverman LE: Hyperthyroidism. Lancet. 388:906–918. 2016.PubMed/NCBI View Article : Google Scholar
2	Vallabhajosula S, Radhi S, Cevik C, Alalawi R, Raj R and Nugent K: Hyperthyroidism and pulmonary hypertension: An important association. Am J Med Sci. 342:507–512. 2011.PubMed/NCBI View Article : Google Scholar
3	Rao G, Verma R, Mukherjee A, Haldar C and Agrawal NK: Melatonin alleviates hyperthyroidism induced oxidative stress and neuronal cell death in hippocampus of aged female golden hamster, mesocricetus auratus. Exp Gerontol. 82:125–130. 2016.PubMed/NCBI View Article : Google Scholar
4	Karunakaran P, Maharajan C, Mohamed KN and Rachamadugu SV: Rapid restoration of bone mass after surgical management of hyperthyroidism: A prospective case control study in Southern India. Surgery. 159:771–776. 2016.PubMed/NCBI View Article : Google Scholar
5	Liu C, Zhang Y, Fu T, Liu Y, Wei S, Yang Y, Zhao D, Zhao W, Song M, Tang X and Wu H: Effects of electromagnetic fields on bone loss in hyperthyroidism rat model. Bioelectromagnetics. 38:137–150. 2017.PubMed/NCBI View Article : Google Scholar
6	Muscogiuri G, Palomba S, Caggiano M, Tafuri D, Colao A and Orio F: Low 25 (OH) vitamin D levels are associated with autoimmune thyroid disease in polycystic ovary syndrome. Endocrine. 53:538–542. 2016.PubMed/NCBI View Article : Google Scholar
7	Jahnsen J, Falch JA, Mowinckel P and Aadland E: Vitamin D status, parathyroid hormone and bone mineral density in patients with inflammatory bowel disease. Scand J Gastroenterol. 37:192–199. 2002.PubMed/NCBI View Article : Google Scholar
8	Ogris E: Diagnostic criteria in terminating therapy in basedow hyperthyroidism. Acta Med Austriaca. 14:77–84. 1987.PubMed/NCBI
9	Mihai S, Codrici E, Popescu ID, Enciu AM, Albulescu L, Necula LG, Mambet C, Anton G and Tanase C: Inflammation-related mechanisms in chronic kidney disease prediction, progression, and outcome. J Immunol Res. 2018(2180373)2018.PubMed/NCBI View Article : Google Scholar
10	Golia E, Limongelli G, Natale F, Fimiani F, Maddaloni V, Pariggiano I, Bianchi R, Crisci M, D'Acierno L, Giordano R, et al: Inflammation and cardiovascular disease: From pathogenesis to therapeutic target. Curr Atheroscler Rep. 16(435)2014.PubMed/NCBI View Article : Google Scholar
11	Choi YJ: Dual-Energy X-ray absorptiometry: Beyond bone mineral density determination. Endocrinol Metab (Seoul). 31:25–30. 2016.PubMed/NCBI View Article : Google Scholar
12	Zhang Y, Liu F, Sun W, Huang Y, Zhang W, Wang B, Su S, Gao Y, Gao Y, Yang H and Guo X: Establishment of reference ranges for thyroid-related indicators in normal pregnant women. Zhonghua Yi Xue Za Zhi. 96:339–343. 2016.PubMed/NCBI View Article : Google Scholar : (In Chinese).
13	Gunatilake SSC and Bulugahapitiya U: Coexistence of primary hyperaldosteronism and graves' disease, a rare combination of endocrine disorders: Is it beyond a coincidence-A case report and review of the literature. Case Rep Endocrinol. 2017(4050458)2017.PubMed/NCBI View Article : Google Scholar
14	Parihar AS, Sood A, Lukose TT, Seam RK and Mittal BR: Metabolic bone superscan in carcinoma breast with occult graves' risease: Looking beyond skeletal metastases. Indian J Nucl Med. 33:145–147. 2018.PubMed/NCBI View Article : Google Scholar
15	Yi HS, Kim JM, Ju SH, Lee Y, Kim HJ and Kim KS: Multiple fractures in patient with graves' disease accompanied by isolated hypogonadotropic hypogonadism. J Bone Metab. 23:40–44. 2016.PubMed/NCBI View Article : Google Scholar
16	Li LX, Deng K and Qu Y: Acupuncture treatment for post-stroke dysphagia: An update meta-analysis of randomized controlled trials. Chin J Integr Med. 24:686–695. 2018.PubMed/NCBI View Article : Google Scholar
17	Graves KL and Vigerust DJ: Hp: An inflammatory indicator in cardiovascular disease. Future Cardiol. 12:471–481. 2016.PubMed/NCBI View Article : Google Scholar
18	Walker NF, Scriven J, Meintjes G and Wilkinson RJ: Immune reconstitution inflammatory syndrome in HIV-infected patients. HIV AIDS (Auckl). 7:49–64. 2015.PubMed/NCBI View Article : Google Scholar
19	Ahn HY, Chung YJ and Cho BY: Serum 25-hydroxyvitamin D might be an independent prognostic factor for graves disease recurrence. Medicine (Baltimore). 96(e7700)2017.PubMed/NCBI View Article : Google Scholar
20	Bassett JH and Williams GR: Role of thyroid hormones in skeletal development and bone maintenance. Endocr Rev. 37:135–187. 2016.PubMed/NCBI View Article : Google Scholar
21	Williams GR: Thyroid hormone actions in cartilage and bone. Eur Thyroid J. 2:3–13. 2013.PubMed/NCBI View Article : Google Scholar
22	Feng X and McDonald JM: Disorders of bone remodeling. Annu Rev Pathol. 6:121–145. 2011.PubMed/NCBI View Article : Google Scholar
23	Mullur R, Liu YY and Brent GA: Thyroid hormone regulation of metabolism. Physiol Rev. 94:355–382. 2014.PubMed/NCBI View Article : Google Scholar
24	Alemu A, Terefe B, Abebe M and Biadgo B: Thyroid hormone dysfunction during pregnancy: A review. Int J Reprod Biomed (Yazd). 14:677–686. 2016.PubMed/NCBI
25	Zhou P, Cai J and Markowitz M: Absence of a relationship between thyroid hormones and vitamin D levels. J Pediatr Endocrinol Metab. 29:703–707. 2016.PubMed/NCBI View Article : Google Scholar
26	Tanaka T, Narazaki M, Masuda K and Kishimoto T: Regulation of IL-6 in immunity and diseases. Adv Exp Med Biol. 941:79–88. 2016.PubMed/NCBI View Article : Google Scholar
27	Yang L, Pang Y and Moses HL: TGF-Beta and immune cells: An important regulatory axis in the tumor microenvironment and progression. Trends Immunol. 31:220–227. 2010.PubMed/NCBI View Article : Google Scholar
28	Lagoo A, Tseng CK and Sell S: Interleukin 2 produced by activated B lymphocytes acts as an autocrine proliferation-inducing lymphokine. Cytokine. 2:272–279. 1990.PubMed/NCBI View Article : Google Scholar
29	Ward LS and Fernandes GA: Serum cytokine levels in autoimmune and non-autoimmune hyperthyroid states. Braz J Med Biol Res. 33:65–69. 2000.PubMed/NCBI View Article : Google Scholar
30	Maeda K, Mehta H, Drevets DA and Coggeshall KM: IL-6 increases B-cell IgG production in a feed-forward proinflammatory mechanism to skew hematopoiesis and elevate myeloid production. Blood. 115:4699–4706. 2010.PubMed/NCBI View Article : Google Scholar
31	Lv LF, Jia HY, Zhang HF and Hu YX: Expression level and clinical significance of IL-2, IL-6 and TGF-β in elderly patients with goiter and hyperthyroidism. Eur Rev Med Pharmacol Sci. 21:4680–4686. 2017.PubMed/NCBI
32	Numbenjapon N, Costin G, Gilsanz V and Pitukcheewanont P: Low cortical bone density measured by computed tomography in children and adolescents with untreated hyperthyroidism. J Pediatr. 150:527–530. 2007.PubMed/NCBI View Article : Google Scholar
33	Senturk T, Kozaci LD, Kok F, Kadikoylu G and Bolaman Z: Proinflammatory cytokine levels in hyperthyroidism. Clin Invest Med. 26:58–63. 2003.PubMed/NCBI
34	Akalin A, Colak O, Alatas O and Efe B: Bone remodelling markers and serum cytokines in patients with hyperthyroidism. Clin Endocrinol (Oxf). 57:125–129. 2002.PubMed/NCBI View Article : Google Scholar