Is Partial or Total Thyroidectomy Associated with Risk of Long-Term Osteoporosis

A Nationwide Population-Based Study

Chien Ling Hung, Chih Ching Yeh, Pi Shan Sung, Chung Jye Hung, Chih Hsin Muo, Fung Chang Sung, I. Ming Jou, Kuen Jer Tsai

Research output: Contribution to journalArticle

Abstract

Background: Whether thyroidectomy contributes to osteoporosis (OP) and osteoporotic fracture (OF) is a subject of debate. This study aimed to determine the effect of thyroidectomy on the risk of OP and OF. Methods: This retrospective cohort study is based on patient data between January 2000 to December 2005 from the National Health Insurance Research Database. Patients who underwent thyroidectomy were enrolled in the thyroidectomy cohort, and the control cohort was selected by propensity score matching at a ratio of 1:4. Incident OP and OF cases were identified until the end of 2013. The thyroidectomy cohort to control cohort adjusted hazard ratio (aHR) for OP/OF was assessed through multivariable Cox proportional hazard regression analysis. Results: Totals of 1426 and 5704 patients were included in the thyroidectomy and control cohorts, respectively. The incidence density of OP was higher in the thyroidectomy cohort (7.91/1000 person-years) than in the control cohort (5.98/1000 person-years), with an aHR of 1.43 (95% CI 1.16–1.77, p < 0.05). Younger patients, women, and patients with comorbidities were at a higher risk. The risks of postoperative OP/OF were significantly increased in patients who received thyroxine treatment for more than 1 year, both in the partial thyroidectomy group and in the total and subtotal thyroidectomy group (aHR: 2.47, 95% CI: 1.42–2.31 vs. aHR: 1.84, 95% CI: 1.22–2.76). Conclusion: Thyroidectomy significantly increased the long-term risk of OP. Younger patients, women, patients with comorbidities, and patients receiving chronic thyroxin treatment should be monitored for changes in postoperative bone density.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalWorld Journal of Surgery
DOIs
Publication statusAccepted/In press - Mar 14 2018

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Thyroidectomy
Osteoporosis
Osteoporotic Fractures
Population
Thyroxine
Comorbidity
Propensity Score
National Health Programs
Bone Density
Cohort Studies
Retrospective Studies
Regression Analysis
Databases
Incidence

ASJC Scopus subject areas

  • Surgery

Cite this

Is Partial or Total Thyroidectomy Associated with Risk of Long-Term Osteoporosis : A Nationwide Population-Based Study. / Hung, Chien Ling; Yeh, Chih Ching; Sung, Pi Shan; Hung, Chung Jye; Muo, Chih Hsin; Sung, Fung Chang; Jou, I. Ming; Tsai, Kuen Jer.

In: World Journal of Surgery, 14.03.2018, p. 1-8.

Research output: Contribution to journalArticle

Hung, Chien Ling ; Yeh, Chih Ching ; Sung, Pi Shan ; Hung, Chung Jye ; Muo, Chih Hsin ; Sung, Fung Chang ; Jou, I. Ming ; Tsai, Kuen Jer. / Is Partial or Total Thyroidectomy Associated with Risk of Long-Term Osteoporosis : A Nationwide Population-Based Study. In: World Journal of Surgery. 2018 ; pp. 1-8.
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abstract = "Background: Whether thyroidectomy contributes to osteoporosis (OP) and osteoporotic fracture (OF) is a subject of debate. This study aimed to determine the effect of thyroidectomy on the risk of OP and OF. Methods: This retrospective cohort study is based on patient data between January 2000 to December 2005 from the National Health Insurance Research Database. Patients who underwent thyroidectomy were enrolled in the thyroidectomy cohort, and the control cohort was selected by propensity score matching at a ratio of 1:4. Incident OP and OF cases were identified until the end of 2013. The thyroidectomy cohort to control cohort adjusted hazard ratio (aHR) for OP/OF was assessed through multivariable Cox proportional hazard regression analysis. Results: Totals of 1426 and 5704 patients were included in the thyroidectomy and control cohorts, respectively. The incidence density of OP was higher in the thyroidectomy cohort (7.91/1000 person-years) than in the control cohort (5.98/1000 person-years), with an aHR of 1.43 (95{\%} CI 1.16–1.77, p < 0.05). Younger patients, women, and patients with comorbidities were at a higher risk. The risks of postoperative OP/OF were significantly increased in patients who received thyroxine treatment for more than 1 year, both in the partial thyroidectomy group and in the total and subtotal thyroidectomy group (aHR: 2.47, 95{\%} CI: 1.42–2.31 vs. aHR: 1.84, 95{\%} CI: 1.22–2.76). Conclusion: Thyroidectomy significantly increased the long-term risk of OP. Younger patients, women, patients with comorbidities, and patients receiving chronic thyroxin treatment should be monitored for changes in postoperative bone density.",
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AU - Hung, Chien Ling

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AU - Hung, Chung Jye

AU - Muo, Chih Hsin

AU - Sung, Fung Chang

AU - Jou, I. Ming

AU - Tsai, Kuen Jer

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