Osteoporosis in Hyperthyroid Patients Without Traditional Risk Factors: A Hospital-Based Cross-Sectional Study at Tikur Anbessa Specialized Hospital Endocrinology Clinic, Addis Ababa, Ethiopia
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Date
2025
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Addis Ababa Universtity
Abstract
Hyperthyroidism is associated with adverse skeletal outcomes, including low bone mineral density (BMD) and secondary osteoporosis. However, evidence on the magnitude and predictors of osteoporosis among hyperthyroid patients in Ethiopia is lacking.
Objective: To assess the prevalence of osteoporosis and associated factors among hyperthyroid patients attending the Endocrinology Clinic at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
Methods: An institution-based cross-sectional study was conducted on 51 hyperthyroid patients selected through census sampling. Data were collected using interviewer-administered questionnaires and clinical records. BMD was measured by DXA scan and fracture risk assessed using the FRAX tool. Binary logistic regression was performed to identify associated factors, with p<0.05 considered statistically significant.
Results: Of the 51 patients, 37.3% had BMD below the expected range for age, consistent with secondary osteoporosis. The mean Z-score was –1.4. Low BMD was not significantly associated with age, sex, BMI, disease etiology, or treatment regimen. Osteoporosis prevalence was higher among patients with uncontrolled hyperthyroidism (66.7%) than among euthyroid (30.6%) or hypothyroid patients (33.3%). Wayne’s score showed significant correlation with osteoporosis (p=0.035). Vitamin D deficiency and poor dietary diversity were common among osteoporotic patients, but not statistically significant. Multivariable regression did not identify independent predictors. The FRAX tool failed to identify patients within the osteoporotic range.
Conclusion: More than one-third of hyperthyroid patients had osteoporosis, independent of traditional risk factors. Routine BMD assessment should be considered in hyperthyroid patients, as the FRAX tool may underestimate fracture risk in this population.
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Keywords
Osteoporosis, Hyperthyroidism, Overt Hyperthyroidism, Sub clinical Hyperthyroidism, DXA Scan.