SAT-LB090 Osteoporosis in Menopausal Women with Autoimmune Thyroiditis

Introduction. Autoimmune thyroiditis may be an important factor that can affect bone quality. There seems to be a connection between systemic inflammation and impaired bone density. Disturbance in osteclastic activity in new bone formation might be a consequence of chronic inflammatory autoimmune disorders leading to osteopenia or osteoporosis. Aim. To estimate the prevalence of osteoporosis in menopausal women with autoimmune thyroiditis. Patients and method . Cross-sectional study of a tertiary endocrine center. 207 menopausal women diagnosed with autoimmune thyroiditis underwent a bone density scan: dual-energy x-ray absorptiometry (DEXA) along with phospho-calcic (Ca, P, PTH, vit D) and thyroid (TSH, TPO-Ab) profile. Results. The mean age of the patients was 63.24±9.33. According with medical history and treatment 91 (43.9%) patients presented hypothyroidism, 14 (6.8%) hyperthyroidism and 102 (49.3%) without known thyroid dysfunction at the moment of screening. After the DEXA scan 77 patients (37.1%) had a T-score< -2.5 SD, 120 (58%) T-score between -2.5 and -1 SD, and 10 patients (4.9%) a T-score> -1SD. In the group with osteoporotic women 32 (41.5%) had treatment with levothyroxine, 4 (5.2%) had treatment with methimazole and 41 (53.3%) no treatment. In the group with osteopenia 55 women (45.9%) had treatment with levothyroxine, 56 (46.6%) no treatment and 9 patients (7.5%) had treatment with methimazole. In the group with normal BMD 5 patients (50%) had no treatment, 4 (40%) had treatment with levothyroxine and only 1 (10%) was in treatment with methymazole. 193 patients (93.2%) presented normal thyroid function (TSH 0.27-4.20µUI/ml) and only 14 women with autoimmune thyroiditis presented abnormal TSH (6 with TSH> 10 and 8 TSH< 0.27 µUI/ml). All the 6 patients with high TSH were treated with levothyroxin and required an increase in levothyroxine dosage. Of the 8 patients with decreased TSH: 4 were treated with levothyroxin, 3 with methimazole and 1 with no treatment. All these patients required a change in dosage according with TSH values and clinical examination. Conclusions . In our study the prevalence of osteoporosis was 37.1%. The presence of autoimmune thyroiditis was associated with an increased risk of low bone density regardless the thyroid function. In a fairly equal number of cases 41.5% with substitutive treatment (for hypothyroidism) vs. 53.3% untreated (euthyroidism) the diagnosis of osteoporosis was made. From the clinical point of vi