Journal of Clinical Endocrinology & Metabolism, Vol 72, 1189-1194, Copyright © 1991 by Endocrine Society

ARTICLES

Measurement of bone collagen degradation in hyperthyroidism and during thyroxine replacement therapy using pyridinium cross-links as specific urinary markers

RD Harvey, KC McHardy, IW Reid, F Paterson, PD Bewsher, A Duncan and SP Robins
Department of Medicine and Therapeutics, University of Aberdeen, United Kingdom.

Urinary excretion of the bone collagen derived pyridinium cross-links pyridinoline (PYD) and deoxypyridinoline (DPD) was measured in 19 patients (4 M:15 F) with untreated thyrotoxicosis, and 20 pre-, and 20 postmenopausal women taking T4 100-200 micrograms daily for autoimmune hypothyroidism. Both PYD and DPD excretion (nanomoles per mmol creatinine) was elevated in the thyrotoxic patients compared to 287 controls; median 131 vs. 26 and 37.5 vs. 7.2, respectively, P less than 0.0001. In premenopausal women mean urinary pyridinium cross-link excretion and serum osteocalcin levels were similar in both T4-treated and matched control groups, despite suppression of serum TSH concentrations to below 0.1 mU/L in 14 of the 20 taking T4. In postmenopausal women mean (+/- 1 SE) urinary PYD excretion (nanomoles per mmol creatinine) was raised in those taking T4, relative to euthyroid controls; 40.0 +/- 2.7 vs. 32.1 +/- 2.3, P less than 0.05. DPD excretion and serum osteocalcin levels were also higher, but not significantly. When only the T4-treated women with a subnormal serum TSH were considered the difference in PYD excretion was more marked, and mean DPD excretion was also significantly elevated; 13.7 +/- 1.3 vs. 10.1 +/- 0.8, P less than 0.05. Conclusion: bone collagen breakdown is increased in thyrotoxicosis, and in postmenopausal women taking sufficient T4 to suppress serum TSH. Similarly treated premenopausal women appear to be at lower risk.

This article has been cited by other articles:

				B. Biondi and D. S. Cooper The Clinical Significance of Subclinical Thyroid Dysfunction Endocr. Rev., February 1, 2008; 29(1): 76 - 131. [Abstract] [Full Text] [PDF]

				B. Biondi, E. A. Palmieri, M. Klain, M. Schlumberger, S. Filetti, and G. Lombardi Subclinical hyperthyroidism: clinical features and treatment options Eur. J. Endocrinol., January 1, 2005; 152(1): 1 - 9. [Abstract] [Full Text] [PDF]

				G. Van den Berghe, D. Van Roosbroeck, P. Vanhove, P. J. Wouters, L. De Pourcq, and R. Bouillon Bone Turnover in Prolonged Critical Illness: Effect of Vitamin D J. Clin. Endocrinol. Metab., October 1, 2003; 88(10): 4623 - 4632. [Abstract] [Full Text] [PDF]

				K. Tanimoto, M. Imada, S. Ohno, A. Sasaki, K. Honda, and K. Tanne Association between Craniofacial Growth and Urinary Bone Metabolic Markers (Pyridinoline, Deoxypyridinoline) in Growing Rats J. Dent. Res., January 1, 2003; 82(1): 28 - 32. [Abstract] [Full Text] [PDF]

				S. J. Hoffman, J. Vasko-Moser, W. H. Miller, M. W. Lark, M. Gowen, and G. Stroup Rapid Inhibition of Thyroxine-Induced Bone Resorption in the Rat by an Orally Active Vitronectin Receptor Antagonist J. Pharmacol. Exp. Ther., July 1, 2002; 302(1): 205 - 211. [Abstract] [Full Text] [PDF]

				H. Pantazi and P. D. Papapetrou Changes in Parameters of Bone and Mineral Metabolism during Therapy for Hyperthyroidism J. Clin. Endocrinol. Metab., March 1, 2000; 85(3): 1099 - 1106. [Abstract] [Full Text]

				Levothyroxine Suppression of Thyroglobulin in Patients with Differentiated Thyroid Carcinoma J. Clin. Endocrinol. Metab., December 1, 1999; 84(12): 4549 - 4553. [Abstract] [Full Text]

				R. C. Pereira, V. Jorgetti, and E. Canalis Triiodothyronine induces collagenase-3 and gelatinase B expression in murine osteoblasts Am J Physiol Endocrinol Metab, September 1, 1999; 277(3): E496 - E504. [Abstract] [Full Text] [PDF]

				H. N. Rosen, A. C. Moses, J. Garber, D. S. Ross, S. L. Lee, L. Ferguson, V. Chen, K. Lee, and S. L. Greenspan Randomized Trial of Pamidronate in Patients with Thyroid Cancer: Bone Density Is Not Reduced by Suppressive Doses of Thyroxine, But Is Increased by Cyclic Intravenous Pamidronate J. Clin. Endocrinol. Metab., July 1, 1998; 83(7): 2324 - 2330. [Abstract] [Full Text]

				A. Siddiqi, J. M. Burrin, K. Noonan, I. James, D. F. Wood, C. P. Price, and J. P. Monson A Longitudinal Study of Markers of Bone Turnover in Graves' Disease and Their Value in Predicting Bone Mineral Density J. Clin. Endocrinol. Metab., March 1, 1997; 82(3): 753 - 759. [Abstract] [Full Text] [PDF]

				A. D. Toft Thyroxine Therapy N. Engl. J. Med., July 21, 1994; 331(3): 174 - 180. [Full Text]