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PLoS One. 2015;10(12):e0144599.

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

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제1저자 조선욱 · 교신저자 박영주

소속 (5)
  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.

Figures

Fig 1
Fig 1 Correlations between TSHR antibodies and bone turnover markers. Correlations between TSH binding inhibitor immunoglobulin (TBII) levels (%) and bone turnover marker levels including bone-specific alkaline phosphatase (BS-ALP), osteocalcin, and C-telopeptide in stimulating activity (A, B, and C, respectively) and blocking activity groups (D, E, and F, respectively). Stimulating activity, patients with TSHR antibodies with thyroid-stimulating activity; Blocking activity, patients with TSHR antibodies with thyroid-stimulating activity combined with blocking activity.

그림 출처: PubMed Central 공개 논문 (PMC4674124)

Conflict of interest statement

Competing Interests:The authors have declared that no competing interests exist.

그 밖의 정보
출판 형태
Comparative Study, Journal Article, Research Support, Non-U.S. Gov't
저널
PloS one · eISSN 1932-6203
전자 출판
2015-12-09
MeSH
Adult · Autoantibodies / blood · Bone Remodeling / immunology · Case-Control Studies · Female · Graves Disease / blood / immunology · Humans · Immunoglobulins, Thyroid-Stimulating / blood / immunology · Receptors, Thyrotropin / blood · Thyroid Function Tests · Thyroid Hormones / blood
Substances
Autoantibodies · Immunoglobulins, Thyroid-Stimulating · Receptors, Thyrotropin · Thyroid Hormones · thyroid stimulation-blocking antibody · thyrotropin-binding inhibitory immunoglobulin
참고문헌
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