ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Thyroid Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1657617
This article is part of the Research TopicLevothyroxine Therapy in Patients with Hypothyroidism: Volume IIView all 18 articles
99Tc-MDP maintains bone mineral density for postmenopausal differentiated thyroid cancer patients with osteopenia under thyroid stimulating hormone suppression
Provisionally accepted
- 1Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
- 2Yangpu Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: The main determinant of skeletal fragility in postmenopausal patients with differentiated thyroid cancer (DTC) and osteopenia is the thyroid stimulating hormone (TSH) suppressive therapy. Bisphosphates including technetium-99 methylene diphosphonate(99Tc-MDP) in this clinical setting are still scanty. Objective: To investigate the effects of 99Tc-MDP on osteopenia (T-score <-1.0≥-2.5 SD for the lumbar spine by DXA)in postmenopausal women with DTC under TSH suppression therapy compared with routine calcium/vitamin D supplements. Methods: 102 postmenopausal DTC patients with osteopenia under TSH suppression therapy were enrolled in the open-label, prospective study. Patients were divided into 2 groups: calcium/vitamin D supplements (groupCa) and calcium/vitamin D combined 99Tc-MDP (groupmdp) groups. Bone mineral density (BMD) of lumbar spine by DXA before and 12 months after treatment, and bone turnover markers were evaluated at baseline, 6 and 12 months after treatment. Results: The combined 99Tc-MDP treatment showed significant increase in the mean percentage change of lumbar BMD at month 12 as compared with groupCa (t=2.156, p=0.035). A significant decrease in BMD of lumber spine from 0.9148±0.08 to 0.8726±0.08 (t=3.81, p=0.001) at the month 12 was observed in groupCa. The mean percentage change from baseline in the levels of serum β-isomer of C-terminal telopeptide of type I collagen (β-CTX), procollagen type 1 N-terminal propeptide (P1NP) showed that 99Tc-MDP combined treatment significantly increased PINP at month 6 (t=2.37, p = 0.02) and 12 (t=2.224, p = 0.029), and significantly decreased β-CTX at month 12 (t=-2.746, p = 0.008) as compared with groupCa. No severe adverse event was found in any of the 2 groups. Conclusions: 99Tc-MDP is safe and could maintain the lumbar BMD in postmenopausal DTC with osteopenia under TSH suppression therapy during a one-year follow-up study. Calcium/vitamin D supplementation alone could not effectively prevent bone loss in these patients.
Keywords: Differentiated thyroid cancer, 99Tc-MDP, thyroid stimulating hormone suppression, therapy, osteopenia
Received: 01 Jul 2025; Accepted: 10 Sep 2025.
Copyright: © 2025 Zhang, Wang, Sun and Ma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chao Ma, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.