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Fracture risk in patients treated for hyperthyroidism
P Vestergaard1, L Rejnmark, J Weeke
1The Osteoporosis Clinic, Aarhus Amtssygehus, Aarhus University Hospital, Denmark. p-vest@post4.tele.dk
Summary
Hyperthyroidism increases fracture risk, particularly in older adults and for spinal and forearm fractures. Radioactive iodine treatment alone elevates this risk, unlike combined therapies.
Area of Science:
- Endocrinology
- Bone Metabolism
- Epidemiology
Background:
- Hyperthyroidism is associated with bone loss and increased fracture risk.
- Understanding specific risk factors and fracture patterns is crucial for patient management.
Purpose of the Study:
- To investigate fracture risk and identify associated risk factors in patients diagnosed with hyperthyroidism.
- To compare fracture incidence in hyperthyroid patients with matched controls.
Main Methods:
- A historical follow-up study involving 864 patients with diffuse or toxic nodular goiter.
- Patients completed a self-administered questionnaire and were matched with population controls based on age and gender.
Main Results:
- Fracture risk was similar before hyperthyroidism diagnosis but elevated afterward (RR=1.7), especially in those aged 50+ (RR=2.2).
- Increased risk was observed for spine (RR=8.9) and forearm fractures (RR=3.1).
- Radioactive iodine monotherapy increased fracture risk (OR=2.7), whereas combined radioactive iodine and methimazole therapy did not show this elevated risk.
Conclusions:
- Hyperthyroidism is linked to a significant increase in fracture risk.
- Radioactive iodine monotherapy is associated with higher fracture risk compared to combined antithyroid treatments.