| 朱于青,胡芳志,张艳芳,陈静,蔡素丽,孙琳.亚临床甲状腺功能减退症患者骨代谢特点研究[J].济宁医学院学报,2019,42(5):350-355 |
| 亚临床甲状腺功能减退症患者骨代谢特点研究 |
| Clinical study on bone metabolism in patients with subclinical hypothyroidism |
| 投稿时间：2019-07-09 |
| DOI：10.3969/j.issn.1000-9760.2019.05.010 |
| 中文关键词: 亚临床甲减;骨代谢;骨密度 |
| 英文关键词: Subclinical hypothyroidism;Bone metabolism;Bone mineral density |
| 基金项目: |
| 作者 | 单位 | | 朱于青 | 济宁医学院临床学院, 济宁 272067 | | 胡芳志 | 济宁医学院附属医院, 济宁 272029 | | 张艳芳 | 济宁医学院附属医院, 济宁 272029 | | 陈静 | 济宁医学院附属医院, 济宁 272029 | | 蔡素丽 | 济宁医学院附属医院, 济宁 272029 | | 孙琳 | 济宁医学院附属医院, 济宁 272029 |
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| 中文摘要: |
| 目的 观察亚临床甲状腺功能减退对骨密度、骨代谢指标的影响。方法 纳入研究对象271例，其中亚临床甲减患者149例为亚甲减组，健康对照者122例为对照组，检测2组甲状腺功能指标血游离三碘甲状腺原氨酸（FT3）、游离甲状腺激素（FT4）、促甲状腺激素（TSH），骨吸收指标I型胶原C端肽（CTX-1），骨形成指标碱性磷酸酶（ALP）、Ⅰ型前胶原N-末端前肽（PINP），以及血钙（Ca2+）、血磷（Pi3+）水平，并测量腰椎、股骨颈骨密度（Bone mineral density，BMD）水平。结果 1）亚甲减组的骨量较对照组明显减低。按照性别、绝经分层，亚甲减组男性骨量显著低于对照组。亚甲减组绝经前/后女性骨量与对照组无明显差异。2）亚甲减组的骨吸收指标CTX-1水平较对照组升高。按照性别、绝经分层，亚甲减组男性的骨吸收指标CTX-1水平较对照组明显升高；亚甲减组男性的PINP、ALP、钙、磷与对照组无差异；亚甲减组中绝经前/后女性的骨代谢指标与对照组无差异。3） TSH与CTX-1正相关。按照性别、年龄分层，男性TSH和CTX-1正相关。结论 亚甲减男性存在骨量丢失，可能与骨吸收增加有关。 |
| 英文摘要: |
| Objective To observe the effects of subclinical hypothyroidism on bone mineral density and bone metabolism.Methods 271 subjects were selected in the study,including 149 patients with subclinical hypothyroidism and 122 healthy controls.The thyroid function index of blood free triiodothyronine(FT3),free thyroid hormone(FT4) and highly sensitive thyroid stimulating hormone(TSH),and alkaline phosphatase(ALP),procollagen type 1 aminoterminal propeptide(P1NP) as bone formation markers,C-cross-linking terminal telopeptide of type I collagen(CTX-1) as bone resorption marker,and Ca2+,P3+ were measured.Femoral neck and lumbar spine bone mineral density(BMD) were also measured.Results 1)Bone mass in subclinical hypothyroidism group was significantly lower than that in control group.According to the delamination on sex and menopause,bone mass of subclinical hypothyroidism men was significantly lower than that in control group.There was no significant difference in the reduction of bone mass and osteoporosis between premenopausal and postmenopausal women compared with the control group.2)The level of CTX-1 in subclinical hypothyroidism group was higher than that in euthyroidism group.According to the delamination on sex and menopause,the level of CTX-1 in subclinical hypothyroidism men was higher than that in euthyroidism men.No differences were found in P1NP,ALP,Ca2+,P3+ between men in the two groups.There was no difference in bone metabolism markers between subclinical hypothyroidism and euthyroidism women.3)There was a positive correlation between TSH and CTX-1.According to the delamination on sex and menopause,there was a positive correlation between TSH and CTX-1 in males.Conclusion Males with subclinical hypothyroidism exist bone mass loss,which might be associated with the increase of bone resorption. |
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