Longitudinal Changes in Bone Mineral Density and Trabecular Bone Score in Adolescents With Graves' Disease
Authors' conclusion
Low TBS was prevalent among adolescents recently diagnosed with GD. Despite observed improvements, TBSZ remained below zero at follow-up, indicating incomplete recovery. As FT4 negatively impacts TBS improvement, maintaining optimal FT4 concentrations early in the disease is crucial for preserving bone microarchitecture in paediatric GD.
Study context
- Population
- Adolescents with Graves' disease (GD) (age 13.7 ± 2.8 years, 73% female)
- Participants
- 41 adolescents
- Outcome
- Changes in lumbar spine BMD Z-score (LSBMDZ) and TBS Z-score (TBSZ)
- Follow-up
- Median 2.2 (1.2-2.9) years
Methodological detailsTrabecular bone score (TBS) analysed using iNsight software
- TBS analysed using iNsight software
Main finding
As reported in the abstract
median follow-up
- LSBMDZ normalized, whereas TBSZ remained below zero
- p = 0.007
- LSBMDZ significantly increased from baseline during 28 months of treatment
- p = 0.01
- TBSZ improvement observed during the initial 9 months
- p = 0.046
Observational data: associations, not effects.
Further findings
Baseline bone status in recently diagnosed GD (RGD, ≤6 months)
- Low lumbar spine bone mineral density (LSBMD)
- 18%
- LSBMDZ, median
- −0.7 [−1.5 to −0.4]
- Low TBS
- 58%
- TBSZ, mean
- −1.5 ± 1.3
RGD vs longer disease duration · median follow-up
- Comparable LSBMDZ and TBSZ at follow-up
Improvement by baseline disease duration tertiles
- Improvement in LSBMDZ progressively declined with increasing disease duration
- P = 0.013
- Improvement in TBSZ progressively declined with increasing disease duration
- P = 0.035
Predictors of ∆TBSZ (stepwise regression)
- Time-weighted free thyroxine (FT4) a negative predictor of ∆TBSZ
- P = 0.042
Original publication
Longitudinal Changes in Bone Mineral Density and Trabecular Bone Score in Adolescents With Graves' Disease. Clin Endocrinol (Oxf). Published 21 July 2025. doi:10.
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