Metabolites · 2 authors, 1 centre
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This cross-sectional study of 619 children with various chronic conditions found that abnormal TSH levels were more strongly associated with low lumbar spine BMD z-scores than abnormal T3 or FT4 levels. TSH abnormality was identified as the strongest risk factor for decreased BMD and could serve as an early indicator of bone fragility in pediatric patients.
This cross-sectional study assessed thyroid function (T3, FT4, TSH) and bone mineral density in 619 children with various underlying chronic conditions. The majority of participants (89.9%) had hemato-oncologic or rheumatoid diseases. T3, FT4, and TSH levels were subcategorized based on age-matched reference ranges, and lumbar spine BMD (LSBMD) z-scores were compared across groups. The mean LSBMD z-score was 0.49 ± 1.28, and both lumbar and femoral BMD z-scores were lower in children with abnormal TSH levels. TSH abnormality was identified as the strongest risk factor for decreased LSBMD z-scores, with an approximately six-fold increase in the odds of an LSBMD z-score below −3.0 when adjusted for age, sex, BMI, and underlying conditions. FT4 levels did not serve as an indicator of low BMD. Limitations include the cross-sectional design, uneven disease distribution, and fewer than 10% of participants having abnormal thyroid function. The authors suggest that any TSH level outside the age-specific reference range warrants immediate bone health assessment.
