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Bone Mineral Density in Adult Survivors of Pediatric Differentiated Thyroid Carcinoma: A Longitudinal Follow-Up Study
- Source :
- Thyroid, 31, 11, pp. 1707-1714, Dekker, B L, Muller Kobold, A C, Brouwers, A H, Williams, G R, Nies, M, Klein Hesselink, M S, van der Horst-Schrivers, A N A, Havekes, B, van den Heuvel-Eibrink, M M, van der Pal, H J H, Plukker, J T M, Ronckers, C M, van Santen, H M, Burgerhof, J G M, Corssmit, E P M, Netea-Maier, R T, Peeters, R P, van Dam, E W C M, Boot, A M, Tissing, W J E, Bocca, G & Links, T P 2021, ' Bone Mineral Density in Adult Survivors of Pediatric Differentiated Thyroid Carcinoma : A Longitudinal Follow-Up Study ', Thyroid, vol. 31, no. 11, pp. 1707-1714 . https://doi.org/10.1089/thy.2021.0179, Thyroid, 31, 1707-1714, Thyroid, 31(11), 1707-1714. Mary Ann Liebert Inc., Thyroid, Thyroid, 31(11), 1707-1714. MARY ANN LIEBERT, INC, Thyroid Journal Program, 31(11), 1707-1714. MARY ANN LIEBERT, INC
- Publication Year :
- 2021
-
Abstract
- Contains fulltext : 245660.pdf (Publisher’s version ) (Closed access) Background: Survivors of pediatric differentiated thyroid carcinoma (DTC) receive thyrotropin-suppressive therapy to minimize disease recurrence. However, knowledge about long-term effects of subclinical hyperthyroidism on bone mineral density (BMD) in pediatric DTC survivors is scarce, as is the information regarding long-term consequences of permanent hypoparathyroidism on BMD. We evaluated BMD in pediatric DTC survivors and investigated if BMD was affected by subclinical hyperthyroidism and/or permanent hypoparathyroidism during long-term follow-up. Methods: In this nationwide longitudinal study, we determined BMD in the lumbar spine and femur by dual energy X-ray absorptiometry in 65 pediatric DTC survivors. Measurements were repeated after minimal 5 years of follow-up in 46 pediatric DTC survivors. BMD results were evaluated according to the recommendations of the International Society for Clinical Densitometry (ISCD) and WHO. At both visits, we determined biochemical parameters and markers of bone resorption (C-terminal telopeptide of type I collagen [β-CTX]) and formation (N-propeptide of type I collagen [PINP] and osteocalcin). Results: First and second BMD measurements were done after a median follow-up of 17.0 (interquartile range [IQR] 8.0-25.0) and 23.5 (IQR 14.0-30.0) years after diagnosis, respectively. Median age at diagnosis was 15 years (IQR 13.0-17.0). Twenty-nine percent of the survivors had subclinical hyperthyroidism. In most survivors, BMD T- and Z-scores were within the reference range during both BMD evaluations. However, after 23.5 years of follow-up, a low BMD was found in 13.0%. In the 13 survivors with permanent hypoparathyroidism, BMD values did not differ after 5 years of follow-up compared with baseline values or in comparison with the 33 survivors without permanent hypoparathyroidism. During follow-up, turnover markers β-CTX and PINP remained stable. Conclusions: This longitudinal study of pediatric DTC survivors demonstrated normal and stable median lumbar spine and femur BMD values after a median time of 17 and 23.5 years after diagnosis. However, compared with controls, a lower BMD was still found in 13.0% after prolonged follow-up despite intensive follow-up. Based on the studied follow-up period, these data do not provide convincing evidence in support of standard monitoring of bone mass among DTC survivors, but may be restricted to individual cases at low frequency. Trial Registration: This follow-up study was registered in The Netherlands Trial Register under no. NL3280 (www.trialregister.nl/trial/3280).
- Subjects :
- Male
Oncology
musculoskeletal diseases
endocrine system
medicine.medical_specialty
Adolescent
endocrine system diseases
Endocrinology, Diabetes and Metabolism
MEDLINE
Levothyroxine
Disease
TURNOVER MARKERS
Rare cancers Radboud Institute for Molecular Life Sciences [Radboudumc 9]
Hyperthyroidism
Thyroid carcinoma
Absorptiometry, Photon
Endocrinology
SDG 3 - Good Health and Well-being
Bone Density
Internal medicine
medicine
thyroid cancer
Humans
childhood cancer
Longitudinal Studies
Survivors
Thyroid Neoplasms
THYROTROPIN-SUPPRESSIVE THERAPY
Child
Thyroid cancer
long-term effects
Netherlands
Bone mineral
business.industry
Cancer
LEVOTHYROXINE
WOMEN
hypoparathyroidism
medicine.disease
CANCER
TSH-suppressive therapy
DYSFUNCTION
Hypoparathyroidism
Female
business
bone mineral density
Follow-Up Studies
medicine.drug
Subjects
Details
- ISSN :
- 10507256
- Database :
- OpenAIRE
- Journal :
- Thyroid, 31, 11, pp. 1707-1714, Dekker, B L, Muller Kobold, A C, Brouwers, A H, Williams, G R, Nies, M, Klein Hesselink, M S, van der Horst-Schrivers, A N A, Havekes, B, van den Heuvel-Eibrink, M M, van der Pal, H J H, Plukker, J T M, Ronckers, C M, van Santen, H M, Burgerhof, J G M, Corssmit, E P M, Netea-Maier, R T, Peeters, R P, van Dam, E W C M, Boot, A M, Tissing, W J E, Bocca, G & Links, T P 2021, ' Bone Mineral Density in Adult Survivors of Pediatric Differentiated Thyroid Carcinoma : A Longitudinal Follow-Up Study ', Thyroid, vol. 31, no. 11, pp. 1707-1714 . https://doi.org/10.1089/thy.2021.0179, Thyroid, 31, 1707-1714, Thyroid, 31(11), 1707-1714. Mary Ann Liebert Inc., Thyroid, Thyroid, 31(11), 1707-1714. MARY ANN LIEBERT, INC, Thyroid Journal Program, 31(11), 1707-1714. MARY ANN LIEBERT, INC
- Accession number :
- edsair.doi.dedup.....2c9b1f13d1eaf1722199a6c531377efc