{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:24:00Z","timestamp":1777875840247,"version":"3.51.4"},"reference-count":31,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Survivors of pediatric differentiated thyroid carcinoma (DTC) receive thyrotropin-suppressive therapy to minimize disease recurrence. However, knowledge about long-term effects of subclinical hyperthyroidism on bone mineral density (BMD) in pediatric DTC survivors is scarce, as is the information regarding long-term consequences of permanent hypoparathyroidism on BMD. We evaluated BMD in pediatric DTC survivors and investigated if BMD was affected by subclinical hyperthyroidism and\/or permanent hypoparathyroidism during long-term follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this nationwide longitudinal study, we determined BMD in the lumbar spine and femur by dual energy X-ray absorptiometry in 65 pediatric DTC survivors. Measurements were repeated after minimal 5 years of follow-up in 46 pediatric DTC survivors. BMD results were evaluated according to the recommendations of the International Society for Clinical Densitometry (ISCD) and WHO. At both visits, we determined biochemical parameters and markers of bone resorption (C-terminal telopeptide of type I collagen [\u03b2-CTX]) and formation (N-propeptide of type I collagen [PINP] and osteocalcin).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>First and second BMD measurements were done after a median follow-up of 17.0 (interquartile range [IQR] 8.0\u201325.0) and 23.5 (IQR 14.0\u201330.0) years after diagnosis, respectively. Median age at diagnosis was 15 years (IQR 13.0\u201317.0). Twenty-nine percent of the survivors had subclinical hyperthyroidism. In most survivors, BMD T- and Z-scores were within the reference range during both BMD evaluations. However, after 23.5 years of follow-up, a low BMD was found in 13.0%. In the 13 survivors with permanent hypoparathyroidism, BMD values did not differ after 5 years of follow-up compared with baseline values or in comparison with the 33 survivors without permanent hypoparathyroidism. During follow-up, turnover markers \u03b2-CTX and PINP remained stable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This longitudinal study of pediatric DTC survivors demonstrated normal and stable median lumbar spine and femur BMD values after a median time of 17 and 23.5 years after diagnosis. However, compared with controls, a lower BMD was still found in 13.0% after prolonged follow-up despite intensive follow-up. Based on the studied follow-up period, these data do not provide convincing evidence in support of standard monitoring of bone mass among DTC survivors, but may be restricted to individual cases at low frequency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration:<\/jats:title>\n                    <jats:p>\n                      This follow-up study was registered in The Netherlands Trial Register under no. NL3280 (\n                      <jats:uri xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.trialregister.nl\/trial\/3280\">www.trialregister.nl\/trial\/3280<\/jats:uri>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/thy.2021.0179","type":"journal-article","created":{"date-parts":[[2021,9,13]],"date-time":"2021-09-13T05:52:43Z","timestamp":1631512363000},"page":"1707-1714","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Bone Mineral Density in Adult Survivors of Pediatric Differentiated Thyroid Carcinoma: A Longitudinal Follow-Up Study"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4785-9723","authenticated-orcid":false,"given":"Bernadette L.","family":"Dekker","sequence":"first","affiliation":[{"name":"Internal Medicine, Department of Endocrinology; Departments of University Medical Center Groningen, Groningen, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anneke C.","family":"Muller Kobold","sequence":"additional","affiliation":[{"name":"Laboratory Medicine, University Medical Center Groningen, Groningen, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrienne H.","family":"Brouwers","sequence":"additional","affiliation":[{"name":"Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8555-8219","authenticated-orcid":false,"given":"Graham R.","family":"Williams","sequence":"additional","affiliation":[{"name":"Molecular Endocrinology Laboratory, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6989-6701","authenticated-orcid":false,"given":"Marloes","family":"Nies","sequence":"additional","affiliation":[{"name":"Internal Medicine, Department of Endocrinology; Departments of University Medical Center Groningen, Groningen, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1270-5142","authenticated-orcid":false,"given":"Mari\u00eblle S.","family":"Klein Hesselink","sequence":"additional","affiliation":[{"name":"Internal Medicine, Department of Endocrinology; Departments of University Medical Center Groningen, Groningen, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anouk N.A.","family":"van der Horst-Schrivers","sequence":"additional","affiliation":[{"name":"Internal Medicine, Department of Endocrinology; Departments of University Medical Center Groningen, Groningen, The Netherlands."},{"name":"Division of Endocrinology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bas","family":"Havekes","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marry M.","family":"van den Heuvel-Eibrink","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, The Netherlands."},{"name":"Department of Pediatric Oncology, Sophia Children's Hospital; Rotterdam, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heleen J.H.","family":"van der Pal","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Th. M.","family":"Plukker","sequence":"additional","affiliation":[{"name":"Surgical Oncology, and University Medical Center Groningen, Groningen, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecile M.","family":"Ronckers","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, The Netherlands."},{"name":"Brandenburg Medical School, Institute of Biostatistics and Registry Research, Neuruppin, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanneke M.","family":"van Santen","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, The Netherlands."},{"name":"Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes G.M.","family":"Burgerhof","sequence":"additional","affiliation":[{"name":"Epidemiology; University of Groningen, University Medical Center Groningen, Groningen, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleonora P.M.","family":"Corssmit","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Romana T.","family":"Netea-Maier","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robin P.","family":"Peeters","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine; Erasmus Medical Center, Rotterdam, The Netherlands."},{"name":"Erasmus MC Academic Center for Thyroid Disease, Rotterdam, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eveline W.C.M.","family":"van Dam","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annemieke M.","family":"Boot","sequence":"additional","affiliation":[{"name":"Pediatric Endocrinology, University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Groningen, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wim J.E.","family":"Tissing","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, The Netherlands."},{"name":"Paediatric Oncology, University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Groningen, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianni","family":"Bocca","sequence":"additional","affiliation":[{"name":"Pediatric Endocrinology, University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Groningen, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thera P.","family":"Links","sequence":"additional","affiliation":[{"name":"Internal Medicine, Department of Endocrinology; 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