TSH Suppression Therapy May Affect Bone Health，How to Manage Differentiated Thyroid Cancer Scientifically？

doi:10.12114/j.issn.1007-9572.2021.00.074

Abstract

Abstract: Differentiated thyroid cancer（DTC）is the most common type of thyroid cancer.TSH suppression therapy after thyroidectomy can reduce the risk of tumor recurrence and metastasis.However，long-term TSH suppression therapy can reduce bone mineral density and increase the risk of osteoporosis and bone fracture，which should be highly valued.We analyze the effects and mechanism of TSH suppression therapy on bone，and suggest the physicians to choose individualized treatment based on consideration of DTC recurrence risk，treatment responses and bone imaging information，risks of side effects and to monitor bone metabolic biomarkers，bone mineral density，risk of bone fracture，so as to take effective measures for the protection of bone，which including maintaining a healthy lifestyle，supplementing calcium and vitamin D，and using anti-osteoporosis drugs when necessary.

Key words: Thyroid neoplasms, Osteoporosis, Differentiated thyroid cancer, Thyrotropin, Individualized treatment

摘要： 分化型甲状腺癌（DTC）是患病率最高的甲状腺癌，DTC术后采取促甲状腺激素（TSH）抑制治疗可能减少肿瘤复发与转移风险，但其可能降低患者骨密度，增加骨质疏松及骨折的潜在风险，此不良影响应被充分重视。本文分析TSH抑制治疗对骨骼的影响及其机制，建议临床医生综合考虑DTC复发风险、治疗效果及不良反应风险，对患者采取个体化治疗，并监测患者的骨代谢生化指标、骨密度、骨折风险及骨骼影像学。建议采取措施，保护患者的骨骼，包括保持健康生活方式、合理补充钙剂与维生素D，必要时联合使用抗骨质疏松治疗药物等。

关键词: 甲状腺肿瘤, 骨质疏松, 分化型甲状腺癌, 促甲状腺素, 个体化治疗

SUN Lei,LI Mei. TSH Suppression Therapy May Affect Bone Health，How to Manage Differentiated Thyroid Cancer Scientifically？[J]. Chinese General Practice, 2021, 24(8): 941-946. DOI: 10.12114/j.issn.1007-9572.2021.00.074.
孙磊,李梅. 促甲状腺激素抑制治疗可能影响骨骼健康，分化型甲状腺癌该如何科学管理？[J]. 中国全科医学, 2021, 24(8): 941-946. DOI: 10.12114/j.issn.1007-9572.2021.00.074.

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