porozendoОстеопороз и остеопатииOsteoporosis and Bone Diseases2072-26802311-0716Endocrinology Research Centre10.14341/osteo2007112-19porozendo-4226Research ArticleСтатьиArticlesОПЫТ ПРИМЕНЕНИЯ ПРОФИЛАКТИЧЕСКОЙ ДОЗЫ АЛЕНДРОНАТА (ФОСАМАКС 35 мг) ДЛЯ ЛЕЧЕНИЯ ОСТЕОПОРОЗА у женщин в постменопаузес субклиническим тиреотоксикозомOPYT PRIMENENIYa PROFILAKTIChESKOY DOZY ALENDRONATA (FOSAMAKS 35 mg) DLYa LEChENIYa OSTEOPOROZA u zhenshchin v postmenopauzes subklinicheskim tireotoksikozomBELAYaZh E-ROZhINSKAYaL Ya-KOLESNIKOVAG S-IL'INA V-SAZONOVAN I-ChERNOVAT O-ALEKSEEVAT M-DOROFEEVAO K-GOL'DMANE I-PIMENOVAS I-MEL'NIChENKOG A-200715042007101№1 (2007)1219Copyright © BELAYa Z.E., ROZhINSKAYa L.Y., KOLESNIKOVA G.S., IL'IN A.V., SAZONOVA N.I., ChERNOVA T.O., ALEKSEEVA T.M., DOROFEEVA O.K., GOL'DMAN E.I., PIMENOVA S.I., MEL'NIChENKO G.A., 20072007BELAYa Z.E., ROZhINSKAYa L.Y., KOLESNIKOVA G.S., IL'IN A.V., SAZONOVA N.I., ChERNOVA T.O., ALEKSEEVA T.M., DOROFEEVA O.K., GOL'DMAN E.I., PIMENOVA S.I., MEL'NIChENKO G.A.BELAYa Z.E., ROZhINSKAYa L.Y., KOLESNIKOVA G.S., IL'IN A.V., SAZONOVA N.I., ChERNOVA T.O., ALEKSEEVA T.M., DOROFEEVA O.K., GOL'DMAN E.I., PIMENOVA S.I., MEL'NIChENKO G.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.osteo-endojournals.ru/jour/article/view/4226

ЦЕЛЬ ИССЛЕДОВАНИЯ. Оценить эффективность профилактической дозы Алендроната (Фосамакс 35 мг в неделю) для МПК и снижения костной резорбции у женщин в постменопаузе с субклиническим тиреотоксикозом и остеопорозом. МАТЕРИАЛЫ И МЕТОДЫ. Тридцать женщин в постменопаузе (64 (60-69) лет) с остеопорозом (T-score ≤ -2,5) и с субклиническим тиреотоксикозом (77% с эндогенным субклиническим тиреотоксикозом и 23% получали супрессивную терапию L-тироксином после операции по поводу высокодифференцированного рака щитовидной железы) были рандомизированы на 2 группы обследованных: (1) 14 женщин получали Фосамакс 35 мг 1 раз в неделю в комбинации с 1 таблеткой Кальция-Д3 Никомед форте ежедневно (500 мг элементарного кальция и 400 МЕ витамина D); (2) 16 женщин получали 2 таблетки Кальция-Д3 Никомед форте ежедневно (1000 мг элементарного кальция и 800 МЕ витамина D). Всем женщинам было рекомендовано увеличение физической активности. У пациенток с эндогенным субклиническим тиреотоксикозом проводилась терапия для достижения эутиреоза. В начале исследования и через год терапии у всех пациенток оценивались: биохимические параметры (кальций, фосфор, креатинин, щелочная фосфатаза, холестерин, ЛПНП, ЛПВП, триглицериды, ХС/ЛПВП, индекс атерогенности) в сыворотке крови и кальций/креатинин в утренней моче; биохимические маркёры костного метаболизма (остеокальцин (OC) и C-терминальный телопептид коллагена 1 типа в сыворотке крови) и МПК ((DXA) (Prodigy, Lunar)) в поясничном отделе позвоночника (L1-L4), шейке бедренной кости, в целом в бедре и в лучевой кости. РЕЗУЛЬТАТЫ: В начале исследования (1) и (2) группы не различались по исследуемым показателям. Через 12 месяцев маркёры костного метаболизма и общая щелочная фосфатаза статистически значимо снизились в обеих группах. Однако маркёры костного метаболизма были статистически значимо ниже у пациентов (1) группы по сравнению со (2) (p<0,0001 для ОК и СТх). Уровни кальция в крови и моче не изменились в обеих группах. Статистически значимое улучшение липидного профиля было обнаружено в обеих группах: ЛПВП увеличились (р=0,035 в (1) группе; p=0,034 во (2) группе), ХС/ЛПВП (p=0,011 (1); p=0,004 (2)) и индекс атерогенности (p=0,048 (1); p=0,026 (2)) уменьшились. Кроме того, у пациентов (1) группы статистически значимо снизились уровни холестерина (р=0,003); триглицеридов (p=0,016) и ЛПНП (p=0,006). Между собой (1) и (2) группы по уровню липидов не отличались. МПК в (1) группе увеличилась на 7,6% в L1-L4 (p=0,003), на 2,8% в шейке бедра (р=0,013), на 3,3% в целом в бедре (p=0,012) и на 3,2 % в лучевой кости (р=0,047). Во (2) группе МПК статистически значимо не изменилась за год наблюдения. Не было выявлено статистически значимых различий в МПК между (1) и (2) группами как в начале, так и через год лечения. ВЫВОДЫ. Прием профилактической дозы Алендроната (35 мг в неделю) на фоне достижения эутиреоза увеличивает МПК во всех регионах скелета, в том числе и в лучевой кости, и статистически значительнее в сравнении с кальцием и витамином D уменьшает костную резорбцию у женщин в постменопаузе с остеопорозом и субклиническим тиреотоксикозом.

The aim was to estimate the effects of treatment with alendronate (Fosomax 35 mg) in postmenopausal women with osteoporosis and subclinical hyperthyroidism. Thirty postmenopausal women (64 (60-69) years old) with osteoporosis (T-score ≤ -2,5) and subclinical hyperthyroidism (77% with endogenous subclinical hyperthyroidism and 23% on L-thyroxine suppres-sive therapy after thyroidectomy due to differentiated thyroid cancer) were randomly assigned into two groups: 1-14 women received Fosamax 35 mg a week in combination with 500 mg of calcium and 400 UI of Vitamin D3 (VD) daily; 2-16 women received 1000 mg of calcium and 800 UI of VD daily. Euthyroidism was achieved in all women with endogenous subclinical hyperthyroidism. An increase in physical activity was recommended to all patients and a hypolipidemic diet was given to those who had had high cholesterol level. Biochemical parameters (calcium (Ca), phosphorous (P), creatinine (Cre), alkaline phosphatase (ALP), cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides (TG), cholesterol/HDL ratio) in fasting serum as well as calcium/creatinine ratio in fasting urine (U-Ca/U-Cre); biochemical markers of bone metabolism: osteocalcin (OC) and C-terminal telopeptide of type I collagen (b-CTx) serum ("ECLIA", Roche Elecsys 1010/2010), BMD (DXA; Prodigy, Lunar) at the lumbar spine (L1-L4), femoral neck (FN), total hip (TH) and radius total (RT) were measured at the baseline visit and after 1 year of treatment. At the baseline visit there were not found any differences between the 1 and the 2 groups. After 12 months of treatment the markers of bone metabolism as well as ALP decreased significantly in both groups, though the decreases were significantly greater (p<0.001 for both OC and b-CTx) in the 1 versus the 2 group. BMD in the 1 group increased by 7,6% at L1-L4 (p=0,003), 2,8% at FN (р=0,013), 3,3 % at TH (p=0,012) and 3,2 % at RT (р=0,047). There was not detected any BMD loss in the 2 group. The changes were not significant between the two groups. The levels of Ca, P, Cre, U-Ca/U-Cre did not change in both groups. Significant improvements in lipid levels were found: HDL increased (р=0.035 1 group p=0,034 2 group), cholesterol/HDL ratio decreased (p=0,011 - 1; p=0,004 - 2). In addition, cholesterol (р=0,003); TG (p=0,016) and LDL (p=0,006) decreased for patients from the 1 group. Conclusion: The achievement of euthyroidism and Fosamax 35 mg a week increase BMD in all regions of the skeleton in postmenopausal women with osteoporosis and subclinical hyperthyroidism and reduce bone resorption significantly more than Calcium and VD supplementation.

ReferencesБелая Ж.Е., Мельниченко Г.А., Рожинская Л.Я., Фадеев В.В., Алексеева Т.М., Дорофеева О.К., Попова В.Г., Сазонова Н.И., Чернова Т.О., Колесникова Г.С., Ильин А.В. «Минеральная плотность костной ткани и показатели костного метаболизма у женщин в менопаузе с субклиническим тиреотоксикозом различного генеза» // Ж. Остеопороз и остеопатии, 2006 № 1, стр. 13-17.Белая Ж.Е., Мельниченко Г.А., Рожинская Л.Я., Фадеев В.В., Алексеева Т.М., Дорофеева О.К., Попова В.Г., Сазонова Н.И., Чернова Т.О., Колесникова Г.С., Ильин А.В. «Минеральная плотность костной ткани и показатели костного метаболизма у женщин в менопаузе с субклиническим тиреотоксикозом различного генеза» // Ж. Остеопороз и остеопатии, 2006 № 1, стр. 13-17.Крыжова Н.С., Рожинская Л.Я., Ермакова И.П., Ильин А.В., Сазонова Н.И., Мельниченко Г.А.: Влияние статинов в сравнении с кальцием и витамином D на показатели костного метаболизма и минеральную плотность костной ткани у женщин с остеопенией в постменопаузе // Ж. Остеопороз и остеопатии, 2005, № 2, стр. 37-43.Крыжова Н.С., Рожинская Л.Я., Ермакова И.П., Ильин А.В., Сазонова Н.И., Мельниченко Г.А.: Влияние статинов в сравнении с кальцием и витамином D на показатели костного метаболизма и минеральную плотность костной ткани у женщин с остеопенией в постменопаузе // Ж. Остеопороз и остеопатии, 2005, № 2, стр. 37-43.Abe E., Marians R.C., Yu W., Wu X., Ando T., Li Y., Iqbal J., Eldeiry L., Rajendren G., Blair H.C., Davies T.F., Zaidi M.: TSH is a negative regulator of skeletal remodeling // J. Cell, 2003, Vol. 115, pp. 151-162.Abe E., Marians R.C., Yu W., Wu X., Ando T., Li Y., Iqbal J., Eldeiry L., Rajendren G., Blair H.C., Davies T.F., Zaidi M.: TSH is a negative regulator of skeletal remodeling // J. Cell, 2003, Vol. 115, pp. 151-162.Akalin A., Colakt O., Alatast O., Efe B.: Bone remodeling markers and serum cytokines in patients with hyperthyroidism // J. Clinical Endocrinology, 2002 Vol.57 pp.125-129.Akalin A., Colakt O., Alatast O., Efe B.: Bone remodeling markers and serum cytokines in patients with hyperthyroidism // J. Clinical Endocrinology, 2002 Vol.57 pp.125-129.Amato G., Mazziotti G., Sorvillo F., Piscopo M., Lalli E., Biondi B., Iorio S., Molinari A., Giustina A., Carella C.: High serum osteoprotegerin levels in patients with hyperthyroidism: effect of medical treatment // J. Bone, 2004, Vol. 35, pp. 785-791.Amato G., Mazziotti G., Sorvillo F., Piscopo M., Lalli E., Biondi B., Iorio S., Molinari A., Giustina A., Carella C.: High serum osteoprotegerin levels in patients with hyperthyroidism: effect of medical treatment // J. Bone, 2004, Vol. 35, pp. 785-791.Aviram M., Luboshitzky R., Brock J.C.: Lipid and lipoprotein pattern in thyroid dysfunction and the effect of therapy // Clinical Biochemistry, 1982, Vol. 15, pp. 62-66.Aviram M., Luboshitzky R., Brock J.C.: Lipid and lipoprotein pattern in thyroid dysfunction and the effect of therapy // Clinical Biochemistry, 1982, Vol. 15, pp. 62-66.Bagger Y.Z., Tanko L.B., Alexandersen P., Qin G., Christiansen C. Prospective Epidemiological Risk Factors Study Group: Radiographic measure of aorta calcification is a site-specific predictor of bone loss and fracture risk at the hip // J Internal Medicine, 2006, Vol. 259, pp. 598-605.Bagger Y.Z., Tanko L.B., Alexandersen P., Qin G., Christiansen C. Prospective Epidemiological Risk Factors Study Group: Radiographic measure of aorta calcification is a site-specific predictor of bone loss and fracture risk at the hip // J Internal Medicine, 2006, Vol. 259, pp. 598-605.Barsal G., Taneli F., Atay A., Hekimsoy Z., Erciyas F.: Serum osteocalcin levels in hyperthyroidism before and after antithyroid therapy. // Tohoku J. Experimental Medicine, 2004, Vol. 203, pp. 183-188.Barsal G., Taneli F., Atay A., Hekimsoy Z., Erciyas F.: Serum osteocalcin levels in hyperthyroidism before and after antithyroid therapy. // Tohoku J. Experimental Medicine, 2004, Vol. 203, pp. 183-188.Bauer D.C., Mundy G.R.., Jamal S.A. et al.: Statin use, bone mass and fracture: an analysis of two prospective studies // J. Bone Mineral Research, 1999, Vol. 14 (suppl 1): S 179.Bauer D.C., Mundy G.R.., Jamal S.A. et al.: Statin use, bone mass and fracture: an analysis of two prospective studies // J. Bone Mineral Research, 1999, Vol. 14 (suppl 1): S 179.Bauss F., Graham R., Russell G.: Ibandronate in osteoporosis: preclinical data and rationale for intermittent dosing // J. Osteoporosis International, 2004, Vol. 15, pp. 423-433.Bauss F., Graham R., Russell G.: Ibandronate in osteoporosis: preclinical data and rationale for intermittent dosing // J. Osteoporosis International, 2004, Vol. 15, pp. 423-433.Biondi B., Palmieri E.A., Klain M., Schlumberger M., Filetti S., Lombardi G.: Subclinical hyperthyroidism: clinical features and treatment options // European J. Endocrinology, 2005, Vol. 152 pp. 1-9.Biondi B., Palmieri E.A., Klain M., Schlumberger M., Filetti S., Lombardi G.: Subclinical hyperthyroidism: clinical features and treatment options // European J. Endocrinology, 2005, Vol. 152 pp. 1-9.Bjarnason N.H., Riis B.J., Christiansen C.: The effect of Fluvas-tatin in parameters of bone remodeling // Osteoporosis International, 2001, Vol. 12, pp. 380-384.Bjarnason N.H., Riis B.J., Christiansen C.: The effect of Fluvas-tatin in parameters of bone remodeling // Osteoporosis International, 2001, Vol. 12, pp. 380-384.Caparevic Z., Stojanovic D., Ilic V., Bojkovic G., Stojanovic M.: Lipid abnormalities in elderly patients with subclinical hyperthy- roidism // Medicinski pregled, 2003, Vol. 56, pp. 564-567.Caparevic Z., Stojanovic D., Ilic V., Bojkovic G., Stojanovic M.: Lipid abnormalities in elderly patients with subclinical hyperthy- roidism // Medicinski pregled, 2003, Vol. 56, pp. 564-567.Chung Y.-S., Lee M.-D., Lee S.-K., Kim H.-M., Fitzpatrick L.A.: HMG-CoA reductase inhibitors increase BMD in type 2 diabetes mellitus patients // J. Clinics Endocrinology Metabolism, 2000, Vol. 85, pp. 1137-1142.Chung Y.-S., Lee M.-D., Lee S.-K., Kim H.-M., Fitzpatrick L.A.: HMG-CoA reductase inhibitors increase BMD in type 2 diabetes mellitus patients // J. Clinics Endocrinology Metabolism, 2000, Vol. 85, pp. 1137-1142.Cui L., Shin M., Chung E., Lee Y., Kweon S., Park K., Choi J.: Association between bone mineral densities and serum lipid profiles of pre- and post-menopausal rural women in South Korea // Osteoporosis International, 2005, Vol. 16, pp. 1975-1981.Cui L., Shin M., Chung E., Lee Y., Kweon S., Park K., Choi J.: Association between bone mineral densities and serum lipid profiles of pre- and post-menopausal rural women in South Korea // Osteoporosis International, 2005, Vol. 16, pp. 1975-1981.Duntas L.H.: Thyroid disease and lipids // Thyroid, 2002, Vol. 12, pp. 287-293.Duntas L.H.: Thyroid disease and lipids // Thyroid, 2002, Vol. 12, pp. 287-293.Edwards C.J., Hart D.J., Spector T.D.: Oral statins and increased bone-mineral density in postmenopausal women // Lancet, 2000, Vol. 355, pp. 2218-2219.Edwards C.J., Hart D.J., Spector T.D.: Oral statins and increased bone-mineral density in postmenopausal women // Lancet, 2000, Vol. 355, pp. 2218-2219.Faber J., Jensen I.W., Petersen L., Nygaard B., Hegedus L., Siersbak-Nielsen.: Normalization of serum thyrotropin by means of radioiodine treatment in subclinical hyperthyroidism: effect on bone loss in postmenopausal women // Clinical Endocrinology, 1998, Vol. 48, pp. 285-290.Faber J., Jensen I.W., Petersen L., Nygaard B., Hegedus L., Siersbak-Nielsen.: Normalization of serum thyrotropin by means of radioiodine treatment in subclinical hyperthyroidism: effect on bone loss in postmenopausal women // Clinical Endocrinology, 1998, Vol. 48, pp. 285-290.Faber J., Galloe A.M.: Changes in bone mass during prolonged subclinical hyperthyroidism due to L-thyroxine treatment: a meta-analysis // European J. Endocrinology, 1994 Vol.130 pp. 350-356.Faber J., Galloe A.M.: Changes in bone mass during prolonged subclinical hyperthyroidism due to L-thyroxine treatment: a meta-analysis // European J. Endocrinology, 1994 Vol.130 pp. 350-356.Fisher J.E., Rogers M.J., Halasy J.M., Luckman S.P., Hughes D.E., Masarachia P.J., Wesolowski G., Russell R.G.G., Rodan G.A., Reszka A.A.: Alendronate mechanism of action: geranylgeraniol, an intermediate in the mevalonate pathway, prevents inhibition of osteoclast formation, bone resorption and kinase activation in vitro // Proceedings of the National Academy of Sciences of the USA, 1999, Vol. 96, pp. 133-138.Fisher J.E., Rogers M.J., Halasy J.M., Luckman S.P., Hughes D.E., Masarachia P.J., Wesolowski G., Russell R.G.G., Rodan G.A., Reszka A.A.: Alendronate mechanism of action: geranylgeraniol, an intermediate in the mevalonate pathway, prevents inhibition of osteoclast formation, bone resorption and kinase activation in vitro // Proceedings of the National Academy of Sciences of the USA, 1999, Vol. 96, pp. 133-138.Foldes J., Tarjan G., Szathmari M., Varga F., Krasznai I., Horvath C.: Bone mineral density in patients with endogenous subclinical hyperthyroidism: is this thyroid status a risk factor for osteoporosis? // J Clinical Endocrinology, 1993, Vol. 39 pp. 521-527.Foldes J., Tarjan G., Szathmari M., Varga F., Krasznai I., Horvath C.: Bone mineral density in patients with endogenous subclinical hyperthyroidism: is this thyroid status a risk factor for osteoporosis? // J Clinical Endocrinology, 1993, Vol. 39 pp. 521-527.Garnero P., Hausherr E., Chapuy M.C., Meacelli C., Grandjean H., Muller C., Breart G., Meunier P.J., Delmas P.D.: Markers of bone resorption predict hip fracture in elderly women: the Epidos prospective study // J. Bone Mineral Research, 1996, Vol. 11, pp. 1531-1538.Garnero P., Hausherr E., Chapuy M.C., Meacelli C., Grandjean H., Muller C., Breart G., Meunier P.J., Delmas P.D.: Markers of bone resorption predict hip fracture in elderly women: the Epidos prospective study // J. Bone Mineral Research, 1996, Vol. 11, pp. 1531-1538.Garnero P., Dargent-Molina P., Hans D., Schott A.M., Breart G.,Meunier P.J., Delmas P.D. Do markers of bone resorption add to bone mineral density and ultrasonographic heel measurement for the prediction of hip fracture in elderly women? The EPIDOS prospective study // J. Osteoporosis International, 1998, Vol. 8, pp. 563-569.Garnero P., Dargent-Molina P., Hans D., Schott A.M., Breart G.,Meunier P.J., Delmas P.D. Do markers of bone resorption add to bone mineral density and ultrasonographic heel measurement for the prediction of hip fracture in elderly women? The EPIDOS prospective study // J. Osteoporosis International, 1998, Vol. 8, pp. 563-569.Garnero P., Sornay-Rendu E., Claustrat B., Delmas P.D.: Biochemical markers of bone turnover, endogenous hormones and the risk of fractures in postmenopausal women: the OFELY study // J. Bone Miner Research, 2000 Vol. 15, pp. 1526-1536.Garnero P., Sornay-Rendu E., Claustrat B., Delmas P.D.: Biochemical markers of bone turnover, endogenous hormones and the risk of fractures in postmenopausal women: the OFELY study // J. Bone Miner Research, 2000 Vol. 15, pp. 1526-1536.Inoue M., Tawata M., Yokomori N., Endo T., Onaya T.: Expression of thyrotropin receptor on clonal osteoblast-like rat osteosarcoma cells // J. Thyroid, 1998, Vol. 8, pp. 1059-1064.Inoue M., Tawata M., Yokomori N., Endo T., Onaya T.: Expression of thyrotropin receptor on clonal osteoblast-like rat osteosarcoma cells // J. Thyroid, 1998, Vol. 8, pp. 1059-1064.E., Munoz-Torres M., Escobar-Jimenez F., Quesada M., Luna J.D., Olea N.: Antiresorptive therapy in hyperthyroid patients: longitudinal changes in bone and mineral metabolism // J. Clinical Endocrinology and Metabolism, 1997, Vol. 82, pp. 1989-1994.E., Munoz-Torres M., Escobar-Jimenez F., Quesada M., Luna J.D., Olea N.: Antiresorptive therapy in hyperthyroid patients: longitudinal changes in bone and mineral metabolism // J. Clinical Endocrinology and Metabolism, 1997, Vol. 82, pp. 1989-1994.Jodar E., Munoz-Torres M., Escobar-Jimenez F., Quesada-Charneco M., Lund del Castillo J.D.: Bone loss in hyperthyroid patients and in former hyperthyroid patients controlled on medical therapy: influence of aetiology and menopause // J. Clinical Endocrinology (Oxf), 1997, Vol. 47, pp. 279-285.Jodar E., Munoz-Torres M., Escobar-Jimenez F., Quesada-Charneco M., Lund del Castillo J.D.: Bone loss in hyperthyroid patients and in former hyperthyroid patients controlled on medical therapy: influence of aetiology and menopause // J. Clinical Endocrinology (Oxf), 1997, Vol. 47, pp. 279-285.Kisakol G., Kaya A., Gonen S., Tung R.: Bone and calcium metabolism in subclinical autoimmune hyperthyroidism and hypothy- roidism // Endocrine J., 2003, Vol. 50, pp. 657-661.Kisakol G., Kaya A., Gonen S., Tung R.: Bone and calcium metabolism in subclinical autoimmune hyperthyroidism and hypothy- roidism // Endocrine J., 2003, Vol. 50, pp. 657-661.Kosinka A., Syrenicz A., Syrenicz M., Kosinski B., Miazgowski T., Garanty-Bogacka B.: The influence of treatment with substitutive or suppressive doses of thyroxine on biochemical bone turnover markers // Ann Acad Med Stetin, 2005, Vol. 51, pp. 97-104.Kosinka A., Syrenicz A., Syrenicz M., Kosinski B., Miazgowski T., Garanty-Bogacka B.: The influence of treatment with substitutive or suppressive doses of thyroxine on biochemical bone turnover markers // Ann Acad Med Stetin, 2005, Vol. 51, pp. 97-104.Kumeda Y., Inaba M., Tahara H., Kurioka Y., Ishikawa T., Morii H., Nishizawa Y.: Persistent increase in bone turnover in Graves' patients with subclinical hyperthyroidism // J. Clinical Endocrinology and Metabolism, 2000, Vol. 85, pp. 4157-4161.Kumeda Y., Inaba M., Tahara H., Kurioka Y., Ishikawa T., Morii H., Nishizawa Y.: Persistent increase in bone turnover in Graves' patients with subclinical hyperthyroidism // J. Clinical Endocrinology and Metabolism, 2000, Vol. 85, pp. 4157-4161.Kung A., Pang R., Lander I., Lam K., Janus E.: Changes in serum lipoprotein (a) and lipids during treatment of hyperthyroidism // Clinical Chemistry, 1995, Vol. 41, pp. 226-231.Kung A., Pang R., Lander I., Lam K., Janus E.: Changes in serum lipoprotein (a) and lipids during treatment of hyperthyroidism // Clinical Chemistry, 1995, Vol. 41, pp. 226-231.Kung A.W.C., Yeung S.S.C.: Prevention of bone loss induced by thyroxine suppressive therapy in postmenopausal women: the effect of calcium and calcitonin // J. Clinical Endocrinology Metabolism, 1996,Vol. 81, pp. 1232-1236.Kung A.W.C., Yeung S.S.C.: Prevention of bone loss induced by thyroxine suppressive therapy in postmenopausal women: the effect of calcium and calcitonin // J. Clinical Endocrinology Metabolism, 1996,Vol. 81, pp. 1232-1236.Langdahl B.L., Loft A.G., Eriksen E.F., Mosekilde L., Charles P.: Bone mass, bone turnover, calcium homeostasis, and body composition in surgically and radioiodine-treated former hyperthyroid patients // J. Thyroid, 1996, Vol. 3, pp. 169-175.Langdahl B.L., Loft A.G., Eriksen E.F., Mosekilde L., Charles P.: Bone mass, bone turnover, calcium homeostasis, and body composition in surgically and radioiodine-treated former hyperthyroid patients // J. Thyroid, 1996, Vol. 3, pp. 169-175.Liberopoulos E.N., Elisaf M.S.: Dyslipidemia in patients with thyroid disorders // Hormones, 2002, Vol. 4, pp. 218-223; Kung A., Pang R., Lander I., Lam K., Janus E.: Changes in serum lipoprotein (a) and lipids during treatment of hyperthyroidism // Clinical Chemistry, 1995, Vol. 41, pp. 226-231.Liberopoulos E.N., Elisaf M.S.: Dyslipidemia in patients with thyroid disorders // Hormones, 2002, Vol. 4, pp. 218-223; Kung A., Pang R., Lander I., Lam K., Janus E.: Changes in serum lipoprotein (a) and lipids during treatment of hyperthyroidism // Clinical Chemistry, 1995, Vol. 41, pp. 226-231.Mikosch P., Obermayer-Pietsch B., Jost R., Jauk B., Gallowitsch H.J., Kresnik E., Leb G., Lind P.: Bone metabolism in patients with differentiated thyroid carcinoma receiving suppressive levothyroxine treatment // Thyroid, 2003, Vol. 13, pp. 347-356.Mikosch P., Obermayer-Pietsch B., Jost R., Jauk B., Gallowitsch H.J., Kresnik E., Leb G., Lind P.: Bone metabolism in patients with differentiated thyroid carcinoma receiving suppressive levothyroxine treatment // Thyroid, 2003, Vol. 13, pp. 347-356.Morimura T., Tsunekawa K., Kasahara T., Seki K., Ogiwara T., Mori M., Murakami M.: Expression of type 2 iodothyronine deiodinase in human osteoblast is stimulated by thyrotropin // Endocrinology, 2005, Vol. 146, pp. 2077-2084.Morimura T., Tsunekawa K., Kasahara T., Seki K., Ogiwara T., Mori M., Murakami M.: Expression of type 2 iodothyronine deiodinase in human osteoblast is stimulated by thyrotropin // Endocrinology, 2005, Vol. 146, pp. 2077-2084.Mudde A.H., Houben A.J., Nieuwenhuijen K.A.C.: Bone metabolism during anti-thyroid drug treatment of endogenous subclinical hyperthyroidism // J. Clinical Endocrinology (Oxf), 1994, Vol. 41, pp. 421-424.Mudde A.H., Houben A.J., Nieuwenhuijen K.A.C.: Bone metabolism during anti-thyroid drug treatment of endogenous subclinical hyperthyroidism // J. Clinical Endocrinology (Oxf), 1994, Vol. 41, pp. 421-424.Mundy G., Garret R., Harris S., et al.: Stimulation of bone formation in vitro and in rodents by statins // Science, 1999, Vol. 268, pp. 1946-1949.Mundy G., Garret R., Harris S., et al.: Stimulation of bone formation in vitro and in rodents by statins // Science, 1999, Vol. 268, pp. 1946-1949.Murphy E., Williams G.R.: The thyroid and the skeleton // J Clinical Endocrinology, 2004, Vol. 61, pp. 285-298.Murphy E., Williams G.R.: The thyroid and the skeleton // J Clinical Endocrinology, 2004, Vol. 61, pp. 285-298.Norvack D.V. TSH., the bone suppressing hormone // J. Cell, 2003, Vol. 115 pp. 129-130.Norvack D.V. TSH., the bone suppressing hormone // J. Cell, 2003, Vol. 115 pp. 129-130.Oikawa M., Kushida K., Ohishi T., Hoshino H., Suzuki M., Ogihara H., Ishigaki J., Inoue T.: Bone turnover and cortical bone mineral density in the distal radius in patients with hyperthyroidism being treated with antithyroid drugs for various periods of time // J. Clinical Endocrinology, 1999, Vol. 50, pp. 171-176.Oikawa M., Kushida K., Ohishi T., Hoshino H., Suzuki M., Ogihara H., Ishigaki J., Inoue T.: Bone turnover and cortical bone mineral density in the distal radius in patients with hyperthyroidism being treated with antithyroid drugs for various periods of time // J. Clinical Endocrinology, 1999, Vol. 50, pp. 171-176.Papi G., Pearce E.N., Braverman L.E., Betterle C., Roti E.: A clinical and therapeutic approach to thyrotoxicosis with thyroid-stimulating hormone suppression only // American J. Medicine, 2005, Vol. 118, pp. 349-361.Papi G., Pearce E.N., Braverman L.E., Betterle C., Roti E.: A clinical and therapeutic approach to thyrotoxicosis with thyroid-stimulating hormone suppression only // American J. Medicine, 2005, Vol. 118, pp. 349-361.Pols H.A.P., Felsenberg D., Hanley D.A., et al.: Multinational, placebo-controlled, randomized trial of the effects of alendronate on bone density and fracture risk in postmenopausal women with low bone mass: results of the FOSIT study // J. Osteoporosis International, 1999, Vol.9 pp. 461-468.Pols H.A.P., Felsenberg D., Hanley D.A., et al.: Multinational, placebo-controlled, randomized trial of the effects of alendronate on bone density and fracture risk in postmenopausal women with low bone mass: results of the FOSIT study // J. Osteoporosis International, 1999, Vol.9 pp. 461-468.Quan M.L., Pasieka J.L., Rorstad O.: Bone mineral density in well-differentiated thyroid cancer patients treated with suppressive thyroxine: a systematic overview of the literature // J Surgical Oncology, 2002, Vol. 79 pp. 62-70.Quan M.L., Pasieka J.L., Rorstad O.: Bone mineral density in well-differentiated thyroid cancer patients treated with suppressive thyroxine: a systematic overview of the literature // J Surgical Oncology, 2002, Vol. 79 pp. 62-70.Recker D.R., Shapiro B.: The effect of thyroidectomy on bone mineral content in perimenopausal women // Thyroidology, 1989, Vol. 2, pp. 59-65.Recker D.R., Shapiro B.: The effect of thyroidectomy on bone mineral content in perimenopausal women // Thyroidology, 1989, Vol. 2, pp. 59-65.Rizzoli R., Greenspan S.L., Bone G. 3rd, Schnitzer T.J., Watts N.B., Adami S., Foldes A.J., Roux C., Levine M.A., Uebelhart B., Santora A.C. 2nd, Kaur A., Peverly C.A., Orloff J.J., Alendronate Once-Weekly Study Group.: Two-years results of once-weekly administration of Alendronate 70 mg for the treatment of postmenopausal osteoporosis // J. Bone Mineral Research, 2002; Vol.17: 1988-1996.Rizzoli R., Greenspan S.L., Bone G. 3rd, Schnitzer T.J., Watts N.B., Adami S., Foldes A.J., Roux C., Levine M.A., Uebelhart B., Santora A.C. 2nd, Kaur A., Peverly C.A., Orloff J.J., Alendronate Once-Weekly Study Group.: Two-years results of once-weekly administration of Alendronate 70 mg for the treatment of postmenopausal osteoporosis // J. Bone Mineral Research, 2002; Vol.17: 1988-1996.Rosen C.J., Adler R.A.: Longitudinal changes in lumbar bone density among thyrotoxic patients after attainment of euthyroidism // J. Clinical Endocrinology Metabolism, 1992, Vol. 75, pp. 1531-1534.Rosen C.J., Adler R.A.: Longitudinal changes in lumbar bone density among thyrotoxic patients after attainment of euthyroidism // J. Clinical Endocrinology Metabolism, 1992, Vol. 75, pp. 1531-1534.Rosen C.J.: Postmenopausal osteoporosis // The New England J. Medicine, 2005 Vol. 353, pp. 595-603.Rosen C.J.: Postmenopausal osteoporosis // The New England J. Medicine, 2005 Vol. 353, pp. 595-603.Rosen H.N., Moses A.C., Garber J., Ross D.S., Lee S.L., Ferguson L., Chen V., Lee K., Greenspan S.L.: Randomized trial of pamidronate in patients with thyroid cancer: bone density in not reduced by suppressive doses of thyroxine, but is increased by cyclic intravenous pamidronate // J. Clinical Endocrinology and Metabolism, 1998, Vol. 83, pp. 2324-2330.Rosen H.N., Moses A.C., Garber J., Ross D.S., Lee S.L., Ferguson L., Chen V., Lee K., Greenspan S.L.: Randomized trial of pamidronate in patients with thyroid cancer: bone density in not reduced by suppressive doses of thyroxine, but is increased by cyclic intravenous pamidronate // J. Clinical Endocrinology and Metabolism, 1998, Vol. 83, pp. 2324-2330.Schneider R., Reiners C.: The effect of levothyroxine therapy on bone mineral density: a systematic review of the literature // Experimental and clinical endocrinology and diabetes, 2003 Vol. 111 pp. 455-470.Schneider R., Reiners C.: The effect of levothyroxine therapy on bone mineral density: a systematic review of the literature // Experimental and clinical endocrinology and diabetes, 2003 Vol. 111 pp. 455-470.Schnitzer T., Bone H.G., Grepaldi G. et al.: Therapeutic equivalence of alendronate 70 mg once weekly and alendronate 10mg daily in the treatment of osteoporosis // Aging Clinical Experimental Research, 2000; Vol.12 pp. 1-12.Schnitzer T., Bone H.G., Grepaldi G. et al.: Therapeutic equivalence of alendronate 70 mg once weekly and alendronate 10mg daily in the treatment of osteoporosis // Aging Clinical Experimental Research, 2000; Vol.12 pp. 1-12.Simsek G., Karter Y., Aydin S., Uzun H.: Osteoporotic cytokines and bone metabolism on rats with induced hyperthyroidism; changes as a result of reversal to euthyroidism // Chinese J. Physiology, 2003, Vol. 46, pp. 181-186.Simsek G., Karter Y., Aydin S., Uzun H.: Osteoporotic cytokines and bone metabolism on rats with induced hyperthyroidism; changes as a result of reversal to euthyroidism // Chinese J. Physiology, 2003, Vol. 46, pp. 181-186.Sirola J., Honkanen R., Kroger H., Jurvelin J.S., Maenpaa P., Saarikoski S.: Relation of statin use and bone loss: a prospective population-based cohort study in early postmenopausal women // Osteoporosis International, 2002, Vol. 13, pp. 537-541.Sirola J., Honkanen R., Kroger H., Jurvelin J.S., Maenpaa P., Saarikoski S.: Relation of statin use and bone loss: a prospective population-based cohort study in early postmenopausal women // Osteoporosis International, 2002, Vol. 13, pp. 537-541.Tanko L.B., Bagger Y.Z., Christiansen C.: Low bone mineral density in the hip as a marker of advanced atherosclerosis in elderly women // Calciefied Tissue International, 2003, Vol. 73, pp. 15-20.Tanko L.B., Bagger Y.Z., Christiansen C.: Low bone mineral density in the hip as a marker of advanced atherosclerosis in elderly women // Calciefied Tissue International, 2003, Vol. 73, pp. 15-20.Tauchmanova L., Nuzzo V., Del Puente, Fonderico F., Puente A.E., Padulla S., Rossi A., Bifulco G., Lupoli G., Lombardi G.: Reduced bone mass detected by bone quantitative ultrasonometry and DEXA in pre- and postmenopausal women with endogenous subclinical hyper- thyroidism // Maturitas, 2004, Vol.48 pp. 299-306.Tauchmanova L., Nuzzo V., Del Puente, Fonderico F., Puente A.E., Padulla S., Rossi A., Bifulco G., Lupoli G., Lombardi G.: Reduced bone mass detected by bone quantitative ultrasonometry and DEXA in pre- and postmenopausal women with endogenous subclinical hyper- thyroidism // Maturitas, 2004, Vol.48 pp. 299-306.Toivonen J., Tahtela R., Laitinen K., Risteli J., Valimaki M.: Markers of bone turnover in patients with differentiated thyroid cancer with and following withdrawal of thyroxine suppressive therapy // European J. Endocrinology, 1998, Vol. 138, pp. 667-673.Toivonen J., Tahtela R., Laitinen K., Risteli J., Valimaki M.: Markers of bone turnover in patients with differentiated thyroid cancer with and following withdrawal of thyroxine suppressive therapy // European J. Endocrinology, 1998, Vol. 138, pp. 667-673.Tsai J.A., Janson A., Bucht E., Kindmark H., Marcus C., Stark A., Rawet Zemack H., Torring O.: Weak evidence of thyrotropin receptors in primary cultures of human osteoblast-like cells // J. Calcified Tissue International, 2004, Vol. 74, pp. 486-491.Tsai J.A., Janson A., Bucht E., Kindmark H., Marcus C., Stark A., Rawet Zemack H., Torring O.: Weak evidence of thyrotropin receptors in primary cultures of human osteoblast-like cells // J. Calcified Tissue International, 2004, Vol. 74, pp. 486-491.Ugur-Altun B., Altun A., Arikan E., Guldiken S., Tugrul A.: Relationships existing between the serum cytokine levels and bone mineral density in women in the premenopausal period affected by Graves' disease with subclinical hyperthyroidism // Endocrine Research, 2003, Vol. 29 pp. 389-398.Ugur-Altun B., Altun A., Arikan E., Guldiken S., Tugrul A.: Relationships existing between the serum cytokine levels and bone mineral density in women in the premenopausal period affected by Graves' disease with subclinical hyperthyroidism // Endocrine Research, 2003, Vol. 29 pp. 389-398.Uzzan B., Campos J., Cucherat M., Nony P., Boissel J.P. 1996 Effects on bone mass of long term treatment with thyroid hormones: a meta-analysis // J Clinics Endocrinology Metabolism, 1996, Vol. 81 pp.4278-4289.Uzzan B., Campos J., Cucherat M., Nony P., Boissel J.P. 1996 Effects on bone mass of long term treatment with thyroid hormones: a meta-analysis // J Clinics Endocrinology Metabolism, 1996, Vol. 81 pp.4278-4289.Van Beak E., Lowik C., Van Pluijm G., Papapoulos S.: The role of geranylgeranylation in bone resorption and its suppression by bisphosphonates in fetal bone explants in vitro: a clue to the mechanism of action of nitrogen-containing bisphosphonates // J Bone Mineral Research, 1999, Vol. 14, pp. 722-729.Van Beak E., Lowik C., Van Pluijm G., Papapoulos S.: The role of geranylgeranylation in bone resorption and its suppression by bisphosphonates in fetal bone explants in vitro: a clue to the mechanism of action of nitrogen-containing bisphosphonates // J Bone Mineral Research, 1999, Vol. 14, pp. 722-729.Vestergaard P., Mosekilde L. 2003 Hyperthyroidism, Bone Mineral, and Fracture Risk - a meta-analysis // Thyroid, 2003, Vol. 13 pp. 585-593.Vestergaard P., Mosekilde L. 2003 Hyperthyroidism, Bone Mineral, and Fracture Risk - a meta-analysis // Thyroid, 2003, Vol. 13 pp. 585-593.

The authors declare that there are no conflicts of interest present.