TSH Levels And Thyroid Autoimmunity Are Associated With An Increased Risk Of Osteoporosis In Euthyroid Postmenopausal Women

ObjectiveTo analyze the effect of thyroid stimulating hormone(TSH)、thyroid peroxidase antibody(TPOAb)、thyroglobulin antibody(TGAb)on the high risk of osteoporosis in euthyroid postmenopausal women.MethodsA total of 174 postmenopausal women who had visited outpatient department of osteoporosis were retrospectively reviewed during the period from June 2017 to November2018.According the level of T score,the selected women,were divided into two groups,osteoporosis andnon-osteoporosis.Toanalyze the correlation of age,BMI,diabetes,TC,LDL-c,TG,HDL-c,creatinine,TSH,TT3,TT4,TPOAb,TGAb with osteoporosis.To anal yze the association of TT3、TT4、TSH with lumbar Spine BMD,femoral neck BMD,total hip BMD.Logistic multivariate regression analysis was done to determine factors relating to osteoporosis.Results(1)Subjects with osteoporosis were older and leaner,with a longer duration of menopause.Levels of TSH were lower in osteoporosis group(TSH:2.03±1.08 vs 2.40±1.24 m IU/L,p=0.040).With respect to thyroid autoimmunity,the positive percentage of anti-TPO antibodies was higher in osteoporosis group(17.9%vs 6.7%,χ~2=5.13,p=0.024)while no significant difference was observed for anti-TG antibodies(17.9%vs 8.9%,χ~2=3.05,p=0.081).Besides serum creatinine levels,no significant differences on diabetes prevalence and lipid levels between the two groups were found.(2)TSH levels were significantly correlated with LS BMD(r=0.161,P=0.035)and femoral neck BMD(r=0.152,P=0.045)(Fig.1),but not with total hip BMD(r=0.093,P=0.223).Neither TT3 nor TT4 was significantly correlated with BMD at the three skeletal regions.(3)Low normal TSH level and positive TPOAb was an independent risk factor for osteoporosis,with an adjusted odds ratio(OR)of 0.698(95%CI:0.505-0.965,p=0.030)and 3.961(95%CI:1.176-13.345,p=0.026)respectively.Other independent factors for predicting osteoporosis were age(OR:1.109,95%CI:1.041-1.134,p=0.000)and BMI(OR:0854,95%CI:0.766-0.952,p=0.005)Conclusions Low normal TSH level and positive TPOAb are associated with an increased risk of osteoporosis in euthyroid postmenopausal women.