摘要
目的探讨Graves病（GD）患者骨质疏松的患病情况，研究GD患者血清骨钙素、I型前胶原氨基端前肽（PINP）、血清碱性磷酸酶（ALP）、母-I型胶原羧基端肽（β-CTX）等骨转换指标的特征及其与甲状腺激素水平的相关性。方法入选明确诊断GD患者163例，电化学发光法测定甲状腺相关激素水平、骨钙素、PINP、CTX，全自动生化仪测定ALP、血钙、磷及尿钙／肌酐比值，用双能X线吸收骨密度仪（DEXA）测定腰椎正位，左侧股骨近端的骨密度。结果GD患者中，男性43例（26．4％），女性120例（73．6％），平均年龄（47±1）岁。其中骨质疏松37例（22．7％），非骨质疏松的126例（77．3％），按不同骨代谢状态分组比较，校正性别、年龄、体重指数后，骨质疏松组患者骨钙素、ALP、PINP、β-CTX和游离T1（FT3）水平高于非骨质疏松组（P〈0．05或P〈0．01）。校正性别、年龄、体重指数后，骨钙素、PINP、β—CTX水平与FT3水平呈正相关（均P〈0．01）；根据FT3水平四分位数分组，各组骨钙素、PINP、β-CTX水平逐渐上升（P〈0．01）。结论Graves病甲状腺功能亢进患者具有较高的骨质疏松患病比例，高骨转换速率是GD合并骨质疏松患者的显著特征，高甲状腺激素水平是影响其骨转换速率和骨质疏松的重要因素。
Objective To evaluate osteoporosis and the bone turnover markers in patients with Graves＇ disease（GD） and the association of bone turnover markers including serum osteocalcin （OCN） , I procollagen N- terminal propeptide（PINP）, serum alkaline phosphatase（ALP）, and β-I collagen carboxyl-terminal peptide（ β- CTX）with thyroid hormone levels. Methods A total of 163 patients with Graves＇ disease were enrolled. Serum thyroid hormone, OCN, PINP, and β-CTX levels were measured by the method of ethehemiluminescence. Serum ALP, calcium, phosphorus, and urinary calcium/creatinine ratio were measured by automatic biochemical system. Bone mineral density （BMD） of lumbar spines 1-4 （ L 1-4） and the proximal left femur was detected by dual energy x- ray absorptiometry. Results GD cases enrolled were composed of 43 men（26.4% ） and 120 women（73.6% ）, with an average age of （47 ± 1 ） years. There were 126 cases （77.3%） with normal BMD, and 37 cases （ 22. 7% ） with osteoporosis. OCN, ALP, PINP, β-CTX, and free T3 levels were significantly higher in the group of osteoporosis than those in the group with normal BMD （ P〈0. 05 or P〈0. 01 ） after adjusting for sex, age, and BMI. The levels of OCN, PINP, and β-CTX were positively correlated with serum FT3 level （ all P〈0. 01 ） and were also progressively increased according to the quartile groups of FT3 levels （ P〈0. 01 ） after sex, age, and BMI were adjusted. Conelusion Patients with Graves＇ disease had a high incidence of osteoporosis with characristic high rate of bone turnover, which is related to the raised thyroid hormone levels.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2011年第11期906-910,共5页
Chinese Journal of Endocrinology and Metabolism
