手术去除甲状腺癌后进行的左旋甲状腺素抑制疗法被认为是骨质疏松和易碎性骨折的危险因素。我们评估了常规运动和运动习惯改变与40岁以上接受甲状腺癌甲状腺切除术的成年人骨折风险的关联。我们从韩国国家医疗保险服务数据中招募了2010年至2016年间年龄在40岁以上的甲状腺癌甲状腺切除术患者，并对其进行了2019年的随访。根据手术前后2年内的健康检查问卷，评估了每周一次的常规运动情况。作为统计分析的参考组，我们选择了手术前后均不进行运动的持续缺乏体力活动组。对于随访期间新诊断出的骨折，进行了单变量和多变量Cox回归分析以评估风险。我们评估了74,774名受试者，其中2,924人（3.9%）在中位随访时间为4.5年内经历了任何一种骨折。与坚持缺乏体力活动的组相比，术前后均进行运动的组显示出任何一种骨折、椎体骨折和髋关节骨折的风险显著降低：调整风险比为0.848（95%置信区间为0.771-0.932）、0.703（0.591-0.836）和0.405（0.224-0.732）。对于椎体骨折，即使在手术后开始进行常规运动的患者中，也确认了骨折风险的显著减少：调整风险比为0.779（0.648-0.936）。体检启动运动后，患者的椎体骨折风险降低在高风险人群中也是显著的：女性和全甲状腺切除患者。我们建议，在手术后保持或开始常规运动可能有助于预防40岁以上接受甲状腺切除术的甲状腺癌患者骨折。版权所有© 2023 Kim, Han, Jung, Ha, Jeong, Heu, Lee, Lee, Lim, Kim, Kwon, Song和Baek。

Levothyroxine suppressive therapy following thyroidectomy for thyroid cancer patients is considered as a risk factor for osteoporosis and fragility fractures. We evaluated the association of regular exercise and exercise habit change with fracture risk in adults older than 40 years who underwent thyroidectomy for thyroid cancer.We enrolled the patients who underwent thyroidectomy for thyroid cancer older than 40 years between 2010 and 2016 from the Korean National Health Insurance Service data, and they were followed through 2019. Based on the questionnaire of health examination within 2 years before and after surgery, whether regular exercise once a week was evaluated. The reference group for the statistical analysis was the continuing lack of physical activity group that did not exercise before or after surgery. For fractures newly diagnosed during the follow-up period, univariate and multivariate Cox regression analyses were performed for risk evaluation.We evaluated 74,774 subjects, of whom 2,924 (3.9%) experienced any fractures during a median follow-up of 4.5 years. Compared with the group consistently lack of physical activity, the group that exercised before and after surgery showed a significant decrease in the risk of any fracture, vertebral fracture, and hip fracture: adjusted hazard ratio 0.848 (95% Confidence Interval 0.771-0.932), 0.703 (0.591-0.836), and 0.405 (0.224-0.732), respectively. For vertebral fracture, a significant reduction in fracture risk was confirmed even in patients who started their regular exercise after surgery: adjusted hazard ratio 0.779 (0.648-0.936). The risk reduction for vertebral fractures upon the initiation of exercise was found to be significant in the high-risk groups of patients: women and total thyroidectomy patients.We suggest that maintaining or starting regular exercise after surgery may help prevent fractures in thyroid cancer patients older than 40 years who have undergone thyroidectomy.Copyright © 2023 Kim, Han, Jung, Ha, Jeong, Heu, Lee, Lee, Lim, Kim, Kwon, Song and Baek.