Effect of Different Doses of Levothyroxine on Bone Density and Bone Turnover Markers in Premenopausal Women with Thyroid Cancer After Thyroidectomy
JIAN Xuefeng
LIANG Shuo
LI Nana
Abstract：Objective To explore the effects of different doses of levothyroxine on bone mineral density and bone turnover markers in premenopausal women with thyroid cancer after thyroidectomy.Methods A prospective study was conducted on 92 premenopausal women with thyroid cancer who underwent thyroidectomy in the hospital from June 2020 to June 2023.The grouping method was block randomization,and divided into a study group(46 cases,with an inhibitor dosage of 2.5 μg·kg-1 levothyroxine)and control group(46 cases,substitute dose 2.0 μg·kg-1 levothyroxine).Compare bone density,bone turnover markers,bone metabolism,and thyroid function between two groups.Results After treatment,bone mineral density and type Ⅰ collagen carboxy terminal peptide beta special sequence(β-CTX)increased in both groups(P＜0.05),while N-terminal-midfragment of osteocalcin(N-MID)and total N-terminal propeptide of type Ⅰ pro-collag(TPIN)of type Ⅰcollagen decreased in both groups(P＜0.05).However,there was no statistically significant difference in bone mineral density,N-MID,TPIN,β-CTX between the study group and the control group after treatment(P＞0.05).After treatment,the levels of type Ⅰ collagen cross-linked C-terminal peptide(CTX-1)decreased in both groups(P＜0.05),while the levels of osteocalcin(OC)increased in both groups(P＜0.05).However,there was no statistically significant difference in CTX-1 and OC levels between the study group and the control group after treatment(P＞0.05).After treatment,TSH decreased in both groups(P＜0.05),while FT4 and FT3 increased in both groups(P＜0.05).TSH was lower in the study group than in the control group after treatment(P＜0.05),while FT4 and FT3 were higher in the study group than in the control group after treatment(P＜0.05).Conclusion The combination of 131I inhibitory dose and alternative dose of levothyroxine can effectively increase bone density,improve bone metabolism indicators and femoral transition markers in postmenopausal women with thyroid cancer after thyroidectomy.However,the inhibitory dose of levothyroxine can more effectively improve thyroid function.
Keywords：thyroidectomyleft thyroxineradiotherapy with 131Ibone densitybone turnover marker
Publication Date：2026-01-28
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：4( 227-230 )