@phdthesis{Schneider2012,
  author    = {Schneider, Mara},
  title     = {Effects of levothyroxine on bone mineral density, muscle force and bone turnover markers: A cohort study},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-85173},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2012},
  abstract  = {The objective of this prospective observational controlled study was to evaluate potential effects and dose-response relationship of LT4 administration on BMD, parameters of bone and muscle strength, and biochemical variables of calcium homoeostasis and bone turnover.Ninety-seven men and pre-menopausal women after near total thyroidectomy and ¹³¹I remnant ablation for well-differentiated thyroid carcinoma or after strumectomy for non-toxic goitre were stratified by degree of TSH suppression and by gender in three subgroups: 28 men and 46 women on LT4 suppressive treatment and 23 women on LT4 replacement therapy. Patients were matched for age, gender and BMI to 89 healthy controls with a negative history of thyroid disease. Patients and controls were followed and studied for a mean time of 1.1±0.2 years. Peripheral volumetric total and trabecular BMD as well as bone strength (pQCT) were determined at the ultra-distal radius. Central areal BMD (DXA) was measured at the lumbar spine, left and right femoral neck as well as left and right total hip. Maximum grip strength (dynamometer) of the non-dominant forearm and serum markers of calcium and bone metabolism were assessed. BMD at the axial skeleton and muscle strength were not impaired by LT4 medication irrespective of gender, underlying diagnosis or treatment regimen. By contrast, a general trend of inversely affected total and trabecular BMD and of decreased bone strength was detected at the ultra-distal radius. Only in women on LT4 suppressive treatment, loss of total BMD at the ultra-distal radius reached a level of high significance. In women on LT4 replacement therapy, a significant decline of maximum grip strength appeared in comparison with female controls, while appendicular total and trabecular BMD as well as bone strength remained unchanged and did not differ from respective controls. In men on LT4 suppressive treatment, greater reduction of bone strength as compared to female thyroid cancer patients was marginally significant. Calcium balance was stable and serum concentrations of bone metabolism markers levelled off or rather decreased contradicting (high turnover) bone loss. The study did not reveal any dose-related differential influence of LT4 administration either on primary or secondary study endpoints in female patients. A gender-related difference of bone strength in response to LT4 suppressive treatment might not be excluded, as male thyroid cancer patients showed greater decline of bone strength despite unaffected peripheral BMD and muscle strength. In conclusion, there was only little evidence of adverse LT4 effects. For the most part, LT4 administration irrespective of degree of TSH suppression was not associated with low or accelerated loss of BMD at the peripheral and central skeleton and loss of bone and muscle strength, a finding also confirmed biochemically. The ultra-distal radius as a non-weight bearing skeletal site might be at risk for BMD reduction. According to the results, pre-menopausal women on LT4 suppressive therapy might be at risk of bone loss. The more complex approach of this study also took into account biomechanical qualities of bone material as well as structural and geometrical characteristics of bone architecture implying a causal muscle-bone interrelationship.},
  subject      = {Schilddr{\"u}se},
  language  = {en}
}
@phdthesis{Schroeter2009,
  author    = {Schr{\"o}ter, Benedikt Markus},
  title     = {Aufkl{\"a}rung der Funktion von CYR61/ CCN1 in Osteoblasten und Osteoklasten},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-38830},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2009},
  abstract  = {No abstract available},
  subject      = {Osteoblast},
  language  = {de}
}
@phdthesis{Hildebrandt2008,
  author    = {Hildebrandt, Lysann},
  title     = {Das Verh{\"a}ltnis von Muskel- und Knochenmasse bei Kindern und jungen Erwachsenen mit Anorexia nervosa, Hypophosphatasie, Kraniopharyngeom und rheumatischen Erkrankungen},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-30414},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2008},
  abstract  = {Ziel der Studie lag in der Analyse des Zusammenhangs von Muskel- und Knochenmasse als Surrogat f{\"u}r Kraft und Knochenfestigkeit. In der vorliegenden Arbeit wurden 265 gesunde und chronisch kranke Kinder und Jugendliche auf ihre K{\"o}rperzusammensetzung untersucht.(Anorexia nervosa: 40, Hypophosphatasie: 10, Kraniopharyngeom: 12 und juveniles Rheuma: 68, Referenzgruppe: 79 gesunde weissrussische M{\"a}dchen und 56 Jungen). Die Untersuchungsergebnisse der DXA Messungen best{\"a}tigen , dass die Knochenmasse als Surrogat f{\"u}r Festigkeit eng mit der Muskelmasse korreliert. Mit zunehmender Muskelmasse steigt auch der BMC an. Die Ergebnisse der Studie stehen im Einklang mit dem von Frost postuliertem Regelkreis, der einen kausalen Zusammenhang zwischen Muskelkraft und Knochenfestigkeit beschrieb. Generell zeigte sich, dass das Surrogat Knochendichte diesen Zusammenhang weniger scharf beschreibt als die Knochenmasse. Dar{\"u}ber hinaus fanden sich St{\"o}rungen des Regelkreises, deren Ursachen zum Teil Gegenstand der Abkl{\"a}rung in weiterf{\"u}hrenden Studien bleiben.},
  subject      = {Knochenstoffwechsel},
  language  = {de}
}