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Auswirkungen von Schilddrüsenfunktionsstörungen auf den Knochen
- Source :
- Der Internist. 59:661-667
- Publication Year :
- 2018
- Publisher :
- Springer Science and Business Media LLC, 2018.
-
Abstract
- Thyroid hormones are key regulators of skeletal development in childhood and bone homeostasis in adulthood, and thyroid diseases have been associated with increased osteoporotic fractures. Hypothyroidism in children leads to an impaired skeletal maturation and mineralization, but an adequate and timely substitution with thyroid hormones stimulates bone growth. Conversely, hyperthyroidism at a young age accelerates skeletal development, but may also cause short stature because of a premature fusion of the growth plates. Hypothyroidism in adults causes an increase in the duration of the remodeling cycle and, thus, leads to low bone turnover and enhanced mineralization, but an association with a higher fracture risk is less well established. In adults, a surplus of thyroid hormones enhances bone turnover, mostly due to an increased bone resorption driven by osteoclasts. Thus, hyperthyroidism is a well-recognized cause of high-bone turnover secondary osteoporosis, resulting in an increased susceptibility to fragility fractures. Subclinical hyperthyroidism, especially resulting from endogenous disease, also has an adverse effect on bone mineral density and is associated with fractures. In most patients with overt or subclinical hyperthyroidism restoration of the euthyroid status reverses bone loss. In postmenopausal women who receive thyroid-stimulating hormone suppression therapy because of thyroid cancer, antiresorptive treatments may be indicated. Overall, extensive data support the importance of a euthyroid status for bone mineral accrual and growth in childhood as well as maintenance of bone health in adulthood.
- Subjects :
- 0301 basic medicine
Bone mineral
Bone growth
endocrine system
medicine.medical_specialty
endocrine system diseases
business.industry
Osteoporosis
Thyroid
030209 endocrinology & metabolism
medicine.disease
Bone remodeling
03 medical and health sciences
030104 developmental biology
0302 clinical medicine
Endocrinology
medicine.anatomical_structure
Internal medicine
Internal Medicine
medicine
Euthyroid
Secondary osteoporosis
business
Thyroid cancer
Subjects
Details
- ISSN :
- 14321289 and 00209554
- Volume :
- 59
- Database :
- OpenAIRE
- Journal :
- Der Internist
- Accession number :
- edsair.doi...........8c89162569eedd333ef1126cab4d7024