Effects of vitamin D₃ and calcium supplementation on bone of young adults after thyroidectomy of differentiated thyroid carcinoma.

IF 2.9 3区医学 Q2 ENDOCRINOLOGY & METABOLISM Endocrine Pub Date : 2025-06-01 Epub Date: 2025-03-06 DOI:10.1007/s12020-025-04195-x

Lei Sun, Xiaoyun Lin, Naishi Li, Qian Zhang, Yan Jiang, Ou Wang, Weibo Xia, Xiaoping Xing, Xiaoyi Li, Mei Li

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Abstract

Purpose: Differentiated thyroid carcinoma (DTC) is the most frequent endocrine cancer, with a high incidence in young population. Patients with postoperative DTC are usually considered with increased risk of bone loss, possibly due to the thyroid stimulating hormone (TSH) suppression therapy. However, it remains unclear whether vitamin D and calcium supplementation is beneficial on bone metabolism of young patients with vitamin D malnutrition after thyroidectomy of DTC.

Methods: In this one-year prospective study, adult men younger than 50 years or premenopausal women with DTC and vitamin D insufficiency or deficiency were enrolled after thyroidectomy, who were administered with daily supplements of 1000-2000 IU vitamin D₃ and 600 mg of elemental calcium (calcium-D₃) or not. Propensity score matching (PSM) was applied to identify baseline-matched cohorts.

Results: A total of 458 patients with a median age of 37 (range 21-50) years were enrolled, with 94 (20.5%) patients supplemented with calcium-D₃. After PSM, we identified baseline-matched cohorts of 246 DTC patients, of which 82 patients were supplemented with calcium-D₃ and 164 were not. After 12 months' supplementation, lower serum levels of β-CTX (0.27 ± 0.15 vs. 0.35 ± 0.18 ng/ml, P = 0.004), PTH (36.2 ± 12.7 vs. 45.2 ± 14.6 pg/ml, P < 0.001) and higher BMD at lumbar spine (1.8% vs. 0.7%, P = 0.050) and total hip (1.1% vs. -0.4%, P < 0.001) were observed compared to the control group. Among all the 458 patients, increase of 25OHD levels was closely associated with decrease of PTH, ALP and β-CTX levels and improvement in total hip BMD throughout the one-year study period.

Conclusion: Vitamin D and calcium supplements can reduce PTH levels and bone loss, possibly contributing to protecting bone of young DTC patients with vitamin D malnutrition after thyroidectomy.

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补充维生素D3和钙对分化型甲状腺癌甲状腺切除术后年轻人骨骼的影响。

目的：分化型甲状腺癌（DTC）是最常见的内分泌肿瘤，在年轻人群中发病率较高。术后DTC患者通常被认为骨质流失的风险增加，可能是由于促甲状腺激素（TSH）抑制治疗。然而，补充维生素D和钙是否有利于年轻DTC甲状腺切除术后维生素D营养不良患者的骨代谢尚不清楚。方法：在这项为期一年的前瞻性研究中，纳入了甲状腺切除术后年龄小于50岁的成年男性或患有DTC和维生素D不足或缺乏的绝经前女性，每天补充1000-2000 IU维生素D3和600 mg元素钙（钙-D3）或不补充。使用倾向评分匹配（PSM）来识别基线匹配的队列。结果：共纳入458例患者，中位年龄为37岁（21-50岁），其中94例（20.5%）患者补充了钙- d3。在PSM后，我们确定了246例DTC患者的基线匹配队列，其中82例患者补充了钙d3, 164例未补充。补充维生素D和钙12个月后，血清β-CTX（0.27±0.15比0.35±0.18 ng/ml, P = 0.004）、PTH（36.2±12.7比45.2±14.6 pg/ml， P）、PTH（36.2±12.7比45.2±14.6 pg/ml）水平降低，结论补充维生素D和钙可降低PTH水平和骨质流失，可能有助于甲状腺切除术后维生素D营养不良的年轻DTC患者的骨质保护。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

5.40%

发文量

295

审稿时长

1.5 months

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.