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Big Data Articles (National Health Insurance Service Database) - Risk of Osteoporotic Fractures among Patients with Thyroid Cancer: A Nationwide Population-Based Cohort Study
- Eu Jeong Ku, Won Sang Yoo, Yu Been Hwang, Subin Jang, Jooyoung Lee, Shinje Moon, Eun Kyung Lee, Hwa Young Ahn
- Endocrinol Metab. 2025;40(2):225-235. Published online January 15, 2025
- DOI: https://doi.org/10.3803/EnM.2024.2101
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- 1 Web of Science
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Abstract
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Supplementary Material
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ePub - Background
The associations between thyroid cancer and skeletal outcomes have not been thoroughly investigated. We aimed to investigate the risk of osteoporotic fractures in patients with thyroid cancer compared to that in a matched control group.
Methods
This retrospective cohort study included 2,514 patients with thyroid cancer and 75,420 matched controls from the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC, 2006–2019). The rates of osteoporotic fractures were analyzed, and associations with the levothyroxine dose were evaluated.
Results
Patients with thyroid cancer had a significantly lower risk of fracture than did the control group (hazard ratio [HR], 0.81; 95% confidence interval [CI], 0.69 to 0.94; P=0.006). Patients diagnosed with thyroid cancer after the age of 50 years (older cancer group) had a significantly lower risk of fracture than did those in the control group (HR, 0.72; 95% CI, 0.6 to 0.85; P<0.001), especially those diagnosed with spinal fractures (HR, 0.66; 95% CI, 0.51 to 0.85; P=0.001). Patients in the older cancer group started osteoporosis treatment earlier than did those in the control group (65.5±7.5 years vs. 67.3±7.6 years, P<0.001). Additionally, a lower dose of levothyroxine was associated with a reduced risk of fractures.
Conclusion
In the clinical setting, the risk of fracture in women diagnosed with thyroid cancer after the age of 50 years was lower than that in the control group, which was caused by more proactive osteoporosis treatment in postmenopausal women with thyroid cancer. -
Citations
Citations to this article as recorded by
- Assessing the risk of osteoporotic fracture recurrence using CT-based radiomics and machine learning
Xiaoyang Zheng, Caihong Zhu, Rui Zhang, Hongyu Sun
Current Problems in Surgery.2025; 72: 101876. CrossRef - Prospective evidence for the gut–bone axis in osteoporotic fractures: Insights from genetic prediction and metabolite mediators
Binjie Zhu, Xinghao Yu, Huimin Lu, Mingzhu Su, Xiaomin Li, Jianhua Jin, Yongmin Yan, Yi Jin
Bone.2025; 201: 117651. CrossRef
- Assessing the risk of osteoporotic fracture recurrence using CT-based radiomics and machine learning
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