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The Association of Thyroid Function With Bone Density During Childhood
Karlien Veldscholte1,2,3, Mirjana Barjaktarovic1,2,3, Katerina Trajanoska1,4
1Department of Internal Medicine, Erasmus Medical Center, GE Rotterdam, Netherlands.
Insights
Higher free thyroxine (FT4) levels in children are linked to lower bone mass. This study highlights the impact of thyroid function on bone development during childhood.
Area of Science:
- Pediatric Endocrinology
- Bone Biology
- Thyroid Function
Background:
- The skeleton is a known target organ for thyroid hormones.
- Limited data exist on thyroid function's impact on childhood bone health.
Purpose of the Study:
- To investigate the association between thyroid function and bone mass in children.
Main Methods:
- Prospective cohort study of 4204 children.
- Thyroid-stimulating hormone (TSH) and free thyroxine (FT4) measured at age 6.
- Bone density assessed via dual-energy X-ray absorptiometry at ages 6 and 10.
Main Results:
- Inverse association found between TSH and bone mineral density (BMD) at ages 6 and 10.
- Higher FT4 levels correlated with lower BMD and bone mineral content (BMC) cross-sectionally and at age 10.
Conclusions:
- Elevated FT4 concentrations are associated with reduced bone mass in children.
- Findings offer insights into thyroid hormone's role in childhood bone physiology.
Context:
Although the skeleton is a well-known thyroid hormone target organ, very little data are available on the association of thyroid function with bone outcomes during childhood.
Objective:
To study the association of thyroid function with bone mass during childhood.
Design, Setting, And Participants:
Population-based prospective cohort including 4204 children with TSH and free T4 (FT4) measured at the age of 6 years.
Main Outcome Measures:
Bone density was assessed by a total body dual-energy X-ray absorptiometry scan at the median age of 6 years (95% range, 5.6 to 7.9) and at the age of 10 years (95% range, 9.0 to 10.9) in 4204 and 3404 participants, respectively.
Results:
There was an inverse association of TSH with bone mineral density (BMD) at the age of 6 (β -0.028 ± 0.011, P = 0.009) and with follow-up measurements at the age of 10 (β -0.027 ± 0.011, P = 0.014), but not with bone mineral content (BMC) at the age of 6 (β -0.028 ± 0.015, P = 0.06) or for follow-up measurements of BMC at the age of 10 (β -0.011 ± 0.015, P = 0.47). There was an inverse association of FT4 with BMD (β -0.016 ± 0.006, P = 0.014) and BMC (β -0.023 ± 0.009, P = 0.009) cross-sectionally, and also at the age of 10 years (BMD: β -0.018 ± 0.007, P = 0.007; BMC: β -0.021 ± 0.009, P = 0.020).
Conclusion:
A higher FT4 concentration is associated with lower bone mass at the age of 6 and at the age of 10 years. These data provide insights into the effects of thyroid function on bone physiology during childhood.
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