Subclinical Hypothyroidism is Not Associated with Femoral Osteoporosis in Individuals Aged 50 Years or Older

Abstract

Background: Thyroid dysfunction and osteoporosis are conditions strongly associated with aging, and the prevalence of both conditions is expected to increase in the coming decades. Thyroid hormones regulate bone metabolism, and the role of subclinical hypothyroidism on bone mineral density (BMD) is still controversial. Hence, this study aims to assess the association of subclinical hypothyroidism with femoral osteopenia and osteoporosis in individuals aged 50 years or older.

Methodology: This retrospective cohort study was carried out with 864 outpatients having at least one result for TSH levels before the first record of dual-energy X-ray absorptiometry (DXA). The primary endpoints were osteopenia (-2.5 standard deviation (SD) <T-score <-1.0SD) and osteoporosis (T-score ≤-2.5SD). Cox proportional hazards regression assessed the association of subclinical hypothyroidism (TSH ≥4.5 mIU/L) with osteopenia and osteoporosis in unadjusted and covariate-adjusted models. Hazard ratios (HR) and 95% confidence intervals (95%CI) were calculated, and p-values <0.05 were considered statistically significant.

Results: There was no significant association between subclinical hypothyroidism and femoral osteopenia in either unadjusted [HR: 1.149 (0.835-1.580); p=0.394] or fully covariate-adjusted models [HR: 1.069 (0.774-1.477); p=0.687]. Subclinical hypothyroidism was associated with femoral osteoporosis in the unadjusted analysis [HR: 1.981 (1.044-3.757); p= 0.036], but a lack of association occurred and remained after successive covariate-adjustments analyses [HR: 1.392 (0.615-3.152); p=0.428].

Conclusion: Subclinical hypothyroidism is not independently associated with either femoral osteopenia or osteoporosis in individuals aged 50 years or older over a four-year follow-up time.

Keywords: Bone mass density; Osteopenia; Osteoporosis; Subclinical hypothyroidism.