The safety of levothyroxine use with respect to bone mineral density
World Journal of Biology Pharmacy and Health Sciences, 14 (3):
346–354 (June 2023)DOI: 10.30574/wjbphs.2023.14.3.0262
Abstract
Background: Previous studies on bone mineral density (BMD) abnormalities associated with hypothyroidism are scarce and not conclusive. The effect of thyroid hormone therapy on BMD has shown mixed results.
Aim: This study aimed primarily to determine the association between the positive history of levothyroxine administering and the risk of osteoporotic fracture in Jordanian cohort of both genders, including post-menopausal women, who were attended to our rehabilitation clinic.
Methods: This study trial was an observational study, which was conducted retrospectively at Prince Rashid bin Al-Hasan Military Hospital, Royal Medical Services, Irbid, Jordan. The Binary Logistic Regression (BLgR) analysis was conducted for the 2 contrarily Levothyroxine (Tx) comparative group; Tx dependent cohort (Cohort II) versus Non-Tx dependent cohort (Cohort I), against the probability of being on the higher (versus lower) risk of femoral hip osteoporotic fracture (fHOPF). The studied patients were dichotomously categorized into 2 comparative cohorts; non-Levothyroxine dependent cohort Cohort I versus Levothyroxine dependent cohort Cohort II. A Chi Square test was processed across these 2 dichotomized cohorts to express the comparison results as Number (Percentages), strength of associations (odd ratios), Pearson chi-square statistic (χ 2), Goodness of Fit (G-Test of independence), and Pearson (r) and Spearman (ρ) correlations.
Results: The BLgR analysis results revealed that the unadjusted risk ratio for the higher probability of fHOPF in our investigated patients, who were on Thyroxine therapy Tx dependent cohort, Cohort II compared to the Tx independent cohort Cohort I, was 10.969 (95% CI; 4.615-26.072). The explained variations in the fHOPF risk related Tx dependent status on our model of this BLgR based model ranged from 17.9%-23.8% (depending on the inferential Cox & Snell R2 or Nagelkerke R2 methods, respectively) and correctly classified approximately 61.2% of the overall cases. The constructed BLgR model was formulated as e (-0.627+2.395×Tx)/1+ e (-0.627+2.395×Tx).
Conclusion: We revealed that the patients who were used thyroxine therapies (Cohort II patients) had significantly higher proportional distribution of higher risk of fHOPF compared to Cohort I patients 41 (85.4%) vs 55 (34.8%), respectively with an odd ratio of 10.969 (95% CI; 4.62-26.07) and significant positive correlation of 0.429±0.057, χ2=37.889, p-value=0.000.