Publication: Estudio de la densidad mineral ósea, microarquitectura trabecular y marcadores de remodelado óseo en pacientes con carcinoma diferenciado de tiroides a largo plazo
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2018-11-28
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Hawkins Carranza, Federico
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Universidad Complutense de Madrid
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Abstract
Actualmente el carcinoma diferenciado de tiroides (CDT) está presentando un aumento de su incidencia, pero debido a su carácter poco agresivo conlleva largas supervivencias y, por tanto, largos periodos de tiempo bajo tratamiento supresor con levotiroxina (LT4) para inducir un estado de hipertiroidismo subclínico que proteja de futuras recidivas.Hasta la fecha, no existe consenso acerca de las consecuencias sobre la masa ósea de este hipertiroidismo subclínico inducido ya que los diferentes estudios publicados arrojan resultados contradictorios. En general, los trabajos que han intentado dar respuesta a esta problemática han contado con muestras de pacientes pequeñas y periodos de seguimiento a corto-medio plazo además de ser muy escasos los que han valorado la microarquitectura trabecular ósea (Trabecular Bone Score-TBS) o la influencia del hipoparatiroidismo postquirúrgico (hipoPTH) en este tipo de pacientes.Nuestro trabajo es hasta la fecha, según nuestro conocimiento, el primero que unifica la valoración de los efectos del estado menopáusico, la situación de hipoparatiroidismo, los niveles de supresión de TSH y el índice de masa corporal (IMC) sobre la densidad mineral ósea (DMO) y el TBS en la mayor muestra de pacientes con el mayor periodo de seguimiento...
Differentiated thyroid cancer (DTC) currently presents an increase of its incidence; however, due to its low aggressive character it is associated with long survival and, therefore, long periods of suppressive treatment with levothyroxine (LT4) to induce a subclinical hyperthyroidism status that protects from future recidives.There is currently no consensus regarding the consecuences on bone mass of this induced subclinical hyperthyroidism since different studies have shown contradicting results. In general, the research works that have tried to find an answer to this problem have been flawed by small samples, short or medium term follow-up periods and, moreover, there is a paucity of studies that have assessed the bone trabecular microarchitecture (Trabecular Bone Score- TBS) or the influence of the post-surgical hypoparathyroidism (hypoPTH) in these kind of patients.To the best of our knowledge, our study is the first to ever unify the evaluation of the effect of the menopausal state, hypoparathyroidism, TSH suppression levels and body mass index on bone mineral density (BMD) and trabecular bone score (TBS) with the biggest sample during the longest follow-up period...
Differentiated thyroid cancer (DTC) currently presents an increase of its incidence; however, due to its low aggressive character it is associated with long survival and, therefore, long periods of suppressive treatment with levothyroxine (LT4) to induce a subclinical hyperthyroidism status that protects from future recidives.There is currently no consensus regarding the consecuences on bone mass of this induced subclinical hyperthyroidism since different studies have shown contradicting results. In general, the research works that have tried to find an answer to this problem have been flawed by small samples, short or medium term follow-up periods and, moreover, there is a paucity of studies that have assessed the bone trabecular microarchitecture (Trabecular Bone Score- TBS) or the influence of the post-surgical hypoparathyroidism (hypoPTH) in these kind of patients.To the best of our knowledge, our study is the first to ever unify the evaluation of the effect of the menopausal state, hypoparathyroidism, TSH suppression levels and body mass index on bone mineral density (BMD) and trabecular bone score (TBS) with the biggest sample during the longest follow-up period...
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esis de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 29-06-2017