Subclinical hyperthyroidism is associated with low bone mineral density (BMD) and increased fracture risk. In healthy postmenopausal women, association between thyroid-stimulating hormone (TSH) in the normal range and BMD is contradictory. Trabecular bone score (TBS), an index of bone micro-architecture, is often decreased in secondary osteoporosis (OP). The aim was to determine the association between thyroid hormones (TSH, fT4) and BMD, TBS, and the incident 5-year OP fractures, in euthyroid post-menopausal women.
Researchers assessed 1475 women of the CoLaus/OsteoLaus cohort, and evaluated BMD at lumbar spine, femoral neck and total hip, lumbar spine TBS, and vertebral fracture with DXA. Incident major OP fractures were evaluated 5 years later by questionnaire and DXA. Women with anti-osteoporotic, antidiabetic, thyroid-modifying, hormone replacement, or systemic corticoid treatment were excluded.
--533 women met the inclusion criteria. There was no significant association between TSH or fT4 and BMD measures at any site.
--A positive association was found between TSH and TBS, even after adjusting for age, BMI, and duration of menopause.
--After a 5-year follow-up, women with incident major OP fractures had lower TSH levels than women without fractures, while no difference was found for fT4.
Conclusively, TSH levels were favorably associated with TBS and negatively associated with incidence fractures in euthyroid postmenopausal women, without changing BMD.