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PLoS One. 2015 Dec 9;10(12):e0144599. doi: 10.1371/journal.pone.0144599. eCollection 2015.

The Presence of Thyroid-Stimulation Blocking Antibody Prevents High Bone Turnover in Untreated Premenopausal Patients with Graves' Disease.

Author information

1
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
2
Department of Nuclear Medicine, Seoul National University Hospital, Seoul, South Korea.
3
Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
4
Department of Internal Medicine, Boramae Medical Center, Seoul, South Korea.
5
Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea.

Abstract

Osteoporosis-related fractures are one of the complications of Graves' disease. This study hypothesized that the different actions of thyroid-stimulating hormone receptor (TSHR) antibodies, both stimulating and blocking activities in Graves' disease patients might oppositely impact bone turnover. Newly diagnosed premenopausal Graves' disease patients were enrolled (n = 93) and divided into two groups: patients with TSHR antibodies with thyroid-stimulating activity (stimulating activity group, n = 83) and patients with TSHR antibodies with thyroid-stimulating activity combined with blocking activity (blocking activity group, n = 10). From the stimulating activity group, patients who had matched values for free T4 and TSH binding inhibitor immunoglobulin (TBII) to the blocking activity group were further classified as stimulating activity-matched control (n = 11). Bone turnover markers BS-ALP, Osteocalcin, and C-telopeptide were significantly lower in the blocking activity group than in the stimulating activity or stimulating activity-matched control groups. The TBII level showed positive correlations with BS-ALP and osteocalcin levels in the stimulating activity group, while it had a negative correlation with the osteocalcin level in the blocking activity group. In conclusion, the activation of TSHR antibody-activated TSH signaling contributes to high bone turnover, independent of the actions of thyroid hormone, and thyroid-stimulation blocking antibody has protective effects against bone metabolism in Graves' disease.

PMID:
26650844
PMCID:
PMC4674124
DOI:
10.1371/journal.pone.0144599
[Indexed for MEDLINE]
Free PMC Article

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