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Borderline-Low Serum Thyrotropin Level Is Correlated With Increased Fasting Urinary Hydroxyproline Excretion
Jesse C., MD;
Michael, MD
Arch Intern Med. 1992;152(2):360-364.
Abstract
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• Background. —
Recent studies suggest that even mildly supraphysiologic thyroid hormonal status accelerates bone loss. In hyperthyroidism, increased bone resorption is the predominant mechanism for bone loss. We postulated that the changes in thyroid hormone status as reflected by lownormal and minimally subnormal serum thyrotropin level would have an effect on bone turnover and could be detected by a simple, noninvasive marker of bone resorption, fasting urinary total hydroxyproline-cretinine excretion (THP/Cr).
Methods.—
We retrospectively identified ambulatory patients with a restricted range of diagnoses who had had measurements of thyrotropin and THP/Cr performed within ±21 days.
Results.—
Of the 86 patients, 47 had thyrotropin levels greater than 1.0 mU/L. In these patients, no correlation was evident for thyrotropin and THP/Cr. Of the other 39 patients, 11 had suppressed thyrotropin levels (<0.1 mU/L) and showed clearly elevated values for THP/Cr, as expected from previous studies of hyperthyroidism. For 28 patients with thyrotropin in the borderline and low-normal range of 0.1 to 1.0 mU/L, a significant negative correlation with THP/Cr was found. The THP/Cr was positively correlated with serum alkaline phosphatase level, as expected with increased bone turnover.
Conclusions.—
These results add further support to the hypothesis that even a minimal excess of thyroid hormones increases bone turnover and may contribute to accelerated bone loss.
(Arch Intern Med. 1992;152:360-364)
Author Affiliations
From the Bone and Mineral Division (Drs Krakauer and Kleerekoper) and Division of Endocrinology and Metabolism (Dr Krakauer), Henry Ford Hospital, Detroit, Mich.
Footnotes
Accepted for publication September 20, 1991.
Reprint requests to Bone and Mineral Division, K-16, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202-2689 (Dr Krakauer).
360 Arch Intern Med-Vol 152, February 1992 Thyro
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