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Hip fracture is not increased in older women treated with thyroid hormone

(July 2003)

The background of the study. Thyroid hormone therapy can cause osteoporosis, but whether it causes fracture is uncertain. This study was done to determine the relationship between thyroid hormone therapy and hip fracture in older women.

How the study was done. The study subjects were 501 women (age,≥65 years) who were members of a group health plan in California and who had a hip fracture between 1971 and 1975. The controls were 533 women who had not had a hip fracture who were matched to the women with fractures for age and year of entry into the health plan. The medical records of these women were reviewed by a person who did not know whether the woman had a hip fracture. Data were collected on the history of thyroid disease; therapy with thyroid hormone, estrogen, glucocorticoids, and hydrochlorothiazide; menopausal status; visual difficulties; and the number of falls requiring emergency department care.

The results of the study. The women in the hip-fracture and control groups were similar in age, racial/ethnic origin, menopausal status, tobacco and alcohol use, and history of thyroid disease and thyroid hormone therapy. Among the women in the hip-fracture group, 7 percent had a history of hypothyroidism, 3 percent had a history of hyperthyroidism, and 13 percent were taking thyroid hormone, as compared with 6 percent, 2 percent, and 87 percent, respectively, in the control group.

The conclusions of the study. Women aged 65 years and older with a history of thyroid disease or thyroid hormone therapy do not have an increased risk of hip fracture.

The original article. Van Den Eeden SK, Barzilay JI, Ettinger B, Minkoff J. Thyroid hormone use and the risk of hip fracture in women ≥65 years: a case-control study. J Womens Health 2003;12:27-31.