{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T23:11:06Z","timestamp":1783033866423,"version":"3.54.6"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T00:00:00Z","timestamp":1759363200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The main determinant of skeletal fragility in postmenopausal patients with differentiated thyroid cancer (DTC) and osteopenia is thyroid-stimulating hormone (TSH) suppressive therapy. Evidence for the use of bisphosphonates, including technetium-99 methylene diphosphonate (<jats:sup>99<\/jats:sup>Tc-MDP), in this clinical setting remains limited. <\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the effects of <jats:sup>99<\/jats:sup>Tc-MDP on osteopenia (T-score &amp;lt;-1.0\u2265-2.5 SD for the lumbar spine by DXA) in postmenopausal women with DTC under TSH suppression therapy compared with routine calcium\/vitamin D supplementation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 102 postmenopausal patients with DTC and osteopenia under TSH suppression therapy were enrolled in this open-label, prospective study. Patients were divided into two groups: calcium\/vitamin D supplements (group<jats:sub>Ca<\/jats:sub>) and calcium\/vitamin D plus <jats:sup>99<\/jats:sup>Tc-MDP (group<jats:sub>mdp<\/jats:sub>) groups. Lumbar spine bone mineral density (BMD) by DXA was measured before and 12 months after treatment. Bone turnover markers were evaluated at baseline, 6 months, and 12 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The combined <jats:sup>99<\/jats:sup>Tc-MDP treatment significantly increased the mean percentage change of lumbar BMD at month 12 compared with group<jats:sub>Ca<\/jats:sub> (t=2.156, p=0.035). A significant decrease in BMD of the lumber spine from 0.9148 \u00b1 0.08 to 0.8726 \u00b1 0.08 (t=3.81, p=0.001) at month 12 was observed in group<jats:sub>Ca<\/jats:sub>. The mean percentage change from baseline in the levels of serum \u03b2-isomer of C-terminal telopeptide of type I collagen (\u03b2-CTX), procollagen type 1 N-terminal propeptide (P1NP) showed that <jats:sup>99<\/jats:sup>Tc-MDP combined treatment significantly increased PINP at month 6 (t=2.37, p = 0.02) and 12 (t=2.224, p = 0.029), and significantly decreased \u03b2-CTX at month 12 (t=-2.746, p = 0.008) compared with group<jats:sub>Ca<\/jats:sub>. No severe adverse events were reported in either group. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:sup>99<\/jats:sup>Tc-MDP is safe and could maintain lumbar BMD in postmenopausal women with DTC and osteopenia under TSH suppression therapy during a 1-year follow-up. Calcium\/vitamin D supplementation alone did not effectively prevent bone loss in these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p>ChiCTR2200064170<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1657617","type":"journal-article","created":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T04:20:47Z","timestamp":1759378847000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["99Tc-MDP maintains bone mineral density for postmenopausal differentiated thyroid cancer patients with osteopenia under thyroid-stimulating hormone 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