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        Thyroid Hormone Therapy Does Not Increase The Risk Of Hip Fracture In Older Women

        A DGReview of :"Thyroid hormone use and the risk of hip fracture in women > or = 65 years: a case-control study"
        Journal of Women's Health

        07/16/2003
        By Mary Beth Nierengarten


        The risk of hip fracture is not increased in women who are 65 or older and take thyroid hormone therapy, reports a study from the Northern California Kaiser Permanente Medical Care Program, a large group practice, managed care organization.

        Although the number of people, particularly older women, who receive thyroid hormone therapy has increased dramatically over the years, few studies have examined whether this therapy increases the risk of fracture.

        To fill this gap, Stephen K. Van den Eeden, PhD, of Kaiser Permanente Northern California, and colleagues conducted a case-control study to assess whether exogenous thyroid hormone therapy in women 65 years of age or older is associated with increased risk of hip fracture. Using data from medical charts, 501 women 65 years or older hospitalized for hip fractures (case subjects) were compared with a control group made up of 533 age-matched women without hip fractures. Thyroid hormone use was similar between the two groups, both in duration and dose.

        Comparison of these two groups showed no association between thyroid hormone therapy and incidence of hip fracture, with an odds ratio of 1.1 between cases and controls. Several factors were found to be associated with hip fractures, including prior history of hyperthyroidism, number of and predisposition to falls, visual impairment, and steroid use.

        Although the authors point out several limitations of this study -- including exclusive focus on hip fractures, the study's limited power, inclusion of bias because of the case-control design, and lack of information on the type of thyroid hormone used and why it was used -- they also emphasize that the strengths of the study included high data integrity and the careful matching of cases and controls.

        Based on this data, the authors conclude that older women on thyroid hormone therapy are not at increased risk of hip fracture.
        J Women's Health 2003;12:127-31. "Thyroid hormone use and the risk of hip fracture in women > or = 65 years: a case-control study"

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