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Bone remodelling markers and serum cytokines in patients with hyperthyroidism
Author(s) -
Akalin Aysen,
Colak Ömer,
Alatas Özkan,
Efe Belgin
Publication year - 2002
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1046/j.1365-2265.2002.01578.x
Subject(s) - medicine , endocrinology , deoxypyridinoline , bone remodeling , graves' disease , bone resorption , osteocalcin , creatinine , thyroid , urinary system , urinary calcium , alkaline phosphatase , chemistry , biochemistry , enzyme
Summary objective This study was designed in order to evaluate bone turnover with bone formation and resorption markers in hyperthyroidism and its possible relationship with serum cytokines interleukin 6 (IL‐6) and tumour necrosis‐α (TNF‐α), levels of thyroid hormones and thyroid autoantibodies. design and patients Twenty‐six hyperthyroid patients including nine with Graves’ disease, 14 with toxic multi‐nodular disease and three toxic adenoma were studied. Twenty normal subjects served as the control group. measurements Serum calcium, phosphorus, total and bone‐specific alkaline phosphatase, procollagen type 1‐C peptide (PICP), osteocalcin, IL‐6 and TNF‐α measurements were performed and deoxypyridinoline (free DPD), calcium, phosphorus and creatinine levels were measured in fasting morning urine specimens of all hyperthyroid patients and all controls. Also, serum total and free T 3 and T 4 and TSH were analysed and thyroid antiperoxidase and antithyroglobulin antibodies were determined in sera of hyperthyroid patients. Patients with hyperthyroidism received propylthiouracil treatment until the achivement of euthyroidism and then serum cytokine levels were remeasured. results Mean serum values of osteocalcin, total and bone‐specific alkaline phosphatase were all significantly higher in hyperthyroid patients than in normal controls. PICP levels were not significantly different between these two groups. Urinary deoxypyridinoline levels were markedly elevated in hyperthyroid patients compared to the control group. There was a significant positive correlation between urinary free DPD levels and serum free T 3 , free T 4 and T 4 levels. Serum free T 4 levels also correlated with urinary calcium levels. Serum IL‐6 values were significantly higher in hyperthyroid patients compared to control group. TNF‐α levels were slightly lower in patients with hyperthyroidism. No significant correlation was found between bone remodelling markers and serum cytokines. Serum Il‐6 levels were correlated positively with age. After the treatment period both IL‐6 and TNF‐α returned to levels comparable with euthyroid controls. conclusion Bone turnover is increased in favour of resorption and the rate of resorption is associated with the levels of thyroid hormones in hyperthyroidism. The increase in the levels of serum IL‐6 in hyperthyroidism is not related directly with bone resorption seen in hyperthyroidism.