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The Negative Correlation Between Thyrotropin Receptor–Stimulating Antibodies and Bone Mineral Density in Postmenopausal Patients With Graves’ Disease
  1. Medea Amashukeli, MD*†,
  2. Maka Korinteli, PhD*†,
  3. Tamar Zerekidze, MD*†,
  4. Nino Jikurauli, MD*†,
  5. Shorena Shanava, MD*†,
  6. Marina Tsagareli, PhD*†,
  7. Elen Giorgadze, PhD*†
  1. From the *Faculty of Medicine, Ivane Javakhishvili Tbilisi State University; and †National Institute of Endocrinology, Tbilisi, Georgia.
  1. Received November 19, 2012, and in revised form February 24, 2013.
  2. Accepted for publication February 25, 2013.
  3. Reprints: Medea Amashukeli, MD, Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, and National Institute of Endocrinology, 2/6 Ljubljana Street, Tbilisi, Georgia 0159. E-mail: medmedea22{at}; medmedea{at}


Graves’ disease is an autoimmune disorder with various clinical manifestations. Thyrotropin receptor antibodies (TRAbs), the circulating autoantibodies specific to Graves’ disease, are the cause for hyperthyroidism, the most prevalent abnormality. Hyperthyroidism leads to increased bone turnover and a negative bone balance. The aims of the present study were to determine the relationship between TRAbs and bone mineral density (BMD), to assess the extent of BMD change in patients with Graves’ disease, and to determine the impact of conservative and surgical therapy on BMD.

Fifty female postmenopausal patients with Graves’ disease were chosen for this study. Twenty women had a recent diagnosis of Graves’ disease, 30 women presented with a compensated disease state after either conservative or surgical treatment, and 30 healthy postmenopausal women served as controls. Thyroid parameters were measured, and BMD values were obtained by dual energy x-ray absorptiometry scan.

Femoral neck and lumbar spine BMD and T-scores were significantly lower in newly diagnosed patients compared with the control group, but a difference was not observed between the treated and control groups. Statistical analysis revealed a strong and significant negative correlation between femoral neck and lumbar spine BMD and TRAb values.

Both surgical and conservative therapies are effective for restoring BMD in postmenopausal patients with Graves’ disease, and the increased level of TRAb can be a useful marker of bone density impairment.

Key Words
  • hyperthyroidism
  • osteoporosis
  • DXA
  • antithyroid drugs
  • surgery

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