A prospective study of thyroid function, bone loss, and fractures in older men: The MrOS study

Avantika C. Waring, Stephanie Harrison, Howard A. Fink, Mary Samuels, Peggy M. Cawthon, Joseph M. Zmuda, Eric Orwoll, Douglas C. Bauer

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Excess thyroid hormone is associated with increased bone loss and fracture risk in older women, but few data exist for men. We sought to determine if thyroid function is independently associated with bone loss and fracture risk in older men. Data were analyzed from the Osteoporotic Fractures in Men (MrOS) study, a cohort of community-dwelling U.S. men aged 65 years and older. Using a case-cohort design, fasting baseline serum archived at -80°C was assayed for thyroid-stimulating hormone (thyrotropin) (TSH) and free thyroxine (FT4) in 397 men with confirmed nonspine fracture, including 157 hip fractures, and 1420 randomly selected men without fracture. TSH and FT4 were analyzed as continuous variables and as thyroid function categories (subclinical hyperthyroid, euthyroid, and subclinical hypothyroid). Hip dual-energy X-ray absorptiometry (DXA) (Hologic QDR4500) was measured at baseline and after a mean follow-up of 4.6 years. Incident nonspine fractures were centrally adjudicated. Bone loss was evaluated with multivariate regression methods and fractures risk was evaluated using hazard models that accounted for the case-cohort sampling, adjusted for age, clinic-site, body mass index (BMI), race, physical activity, corticosteroid use, smoking, alcohol intake, and thyroid medication use. In fully adjusted analyses, TSH was not associated with risk of nonspine fracture (relative hazard [RH] 0.92 per SD decrease in TSH; 95% confidence interval [CI], 0.74-1.14), but was significantly associated with risk of hip fracture (RH 1.31; 95% CI, 1.01-1.71), which persisted among normal range TSH values (RH 1.21; 95% CI, 1.00-1.47). There was no association between TSH or FT4 and bone loss, and fracture risk did not differ significantly by thyroid function category. We conclude that although neither TSH nor FT4 are associated with bone loss, lower serum TSH may be associated with an increased risk of hip fractures in older men.

Original languageEnglish (US)
Pages (from-to)472-479
Number of pages8
JournalJournal of Bone and Mineral Research
Volume28
Issue number3
DOIs
StatePublished - Mar 2013

Fingerprint

Bone Fractures
Thyroid Gland
Prospective Studies
Hip Fractures
Thyrotropin
Confidence Intervals
Independent Living
Bone and Bones
Osteoporotic Fractures
Photon Absorptiometry
Hyperthyroidism
Serum
Thyroxine
Thyroid Hormones
Proportional Hazards Models
Hip
Fasting
Adrenal Cortex Hormones
Reference Values
Body Mass Index

Keywords

  • BONE DENSITY
  • FRACTURE
  • MEN
  • OSTEOPOROSIS
  • THYROID FUNCTION

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

A prospective study of thyroid function, bone loss, and fractures in older men : The MrOS study. / Waring, Avantika C.; Harrison, Stephanie; Fink, Howard A.; Samuels, Mary; Cawthon, Peggy M.; Zmuda, Joseph M.; Orwoll, Eric; Bauer, Douglas C.

In: Journal of Bone and Mineral Research, Vol. 28, No. 3, 03.2013, p. 472-479.

Research output: Contribution to journalArticle

Waring, Avantika C. ; Harrison, Stephanie ; Fink, Howard A. ; Samuels, Mary ; Cawthon, Peggy M. ; Zmuda, Joseph M. ; Orwoll, Eric ; Bauer, Douglas C. / A prospective study of thyroid function, bone loss, and fractures in older men : The MrOS study. In: Journal of Bone and Mineral Research. 2013 ; Vol. 28, No. 3. pp. 472-479.
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