Maturitas 48 (2004) 299–306 Reduced bone mass detected by bone quantitative ultrasonometry and DEXA in pre- and postmenopausal women with endogenous subclinical hyperthyroidism Libuse Tauchmanovà a,∗ , Vincenzo Nuzzo a , Antonio Del Puente b , Francesco Fonderico a , Antonella Esposito-Del Puente b , Stefania Padulla b , Annalisa Rossi a , Giuseppe Bifulco c , Giovanni Lupoli a , Gaetano Lombardi a a Department of Molecular and Clinical Endocrinology and Oncology, Università degli Studi di Napoli “Federico II”, Via S. Pansini 5, 80131 Napoli, Italy b Unit of Rheumatology, University “Federico II” in Naples, Italy c Department of Gynaecology and Obstetrics, University “Federico II” in Naples, Italy Received 13 May 2003; received in revised form 8 January 2004; accepted 23 February 2004 Abstract Background: Although overt hyperthyroidism is a well known cause of bone loss, systemic effects of subclinical hyperthy- roidism (SH) are still a matter of debate. Objective: The aim of this cross-sectional study was to evaluate the effect of endogenous SH on bone in relation to the menopausal status. Methods: Bone mass and turnover were assessed in a group of 60 patients with endogenous SH due to multinodular goitre; 30 of them were premenopausal and 30 early postmenopausal (mean age, 40.9 ± 7.3 and 57.7 ± 6.75, respectively). Sixty healthy women matched for age-, BMI- and menopausal status served as controls. Three different skeletal sites were evaluated using two different techniques: lumbar spine and femoral neck were assessed by DEXA whereas the proximal phalanges were evaluated by quantitative ultrasonometry (QUS), measuring the amplitude-dependent speed of sound (Ad-SoS). Serum osteocalcin and urinary deoxypyridinoline (DPD) were also determined as markers of bone turnover. Results: A significant decrease was found in femoral BMD (P< 0.05) and phalangeal Ad-SoS (P< 0.001) in pre- and postmenopausal patients compared to controls, being greater in those postmenopausal. Lumbar BMD was decreased only in postmenopausal patients (P< 0.05). Bone turnover markers were higher in patients than in controls and in post- than in the premenopausal ones. A significant negative correlation was found between femoral BMD, Ad-SoS and serum free T3 levels, the latter considered a marker of disease activity. Conclusions: A significant increase in bone turnover markers and a decrease in bone mass was found in women affected by endogenous SH, being greater in early postmenopausal patients. Cortical rich bone was mainly affected. Both QUS and the conventional DEXA technique were equally able to determine bone density decrease related to mild thyroid hormone excess and sexual hormone decrease. © 2003 Elsevier Ireland Ltd. All rights reserved. Keywords: Osteopenia; Bone mineral density; Subclinical hyperthyroidism; Quantitative bone ultrasonometry; Pretoxic adenoma; Multinodular goitre ∗ Corresponding author. Tel.: +39-081-746-24-32; fax: +39-081-746-36-68. E-mail address: tauchman@unina.it (L. Tauchmanov` a). 0378-5122/$ – see front matter © 2003 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.maturitas.2004.02.017