Graves病患者血清chemerin水平与骨密度的相关性

发布时间：2018-07-05 05:05

本文选题：趋化素 + 骨密度　；参考：《中南大学学报(医学版)》2017年08期

【摘要】：目的:观察初治甲状腺功能亢进症(甲亢)Graves病(Graves disease,GD)患者脂肪细胞因子趋化素(chemerin)水平的变化,探讨其与骨密度降低的关系。方法:随机收集内分泌科门诊确诊的120例病程3个月的初治甲亢GD患者为GD组,收集同期同院健康体检中心年龄、性别相匹配的健康体检者60人为正常对照组,两组均进行chemerin,骨转换标志物1型胶原羧基端β特殊序列(β-crosslaps,β-CTX)和N端中分子骨钙素(N-MID-osteocalcin,N-MID-OT)检测以及脂肪量、骨密度测量;chemerin,β-CTX及N-MID-OT均采用ELISA法测定;脂肪量、骨密度检查采用双能X线骨密度仪法。结果:GD组患者较正常对照组脂肪量、瘦体重、脂肪量指数(fat mass index,FMI)、体重指数(BMI)下降,各部位骨密度降低,这些因素间呈正相关(均P0.05)。GD组chemerin水平升高,与β-CTX和N-MID-OT呈正相关(rs分别为0.456和0.541,均P0.05),与脂肪量、FMI和BMI呈负相关(rs分别为 0.285, 0.281, 0.275,均P0.05)。GD组chemerin水平与股骨颈、全髋关节、腰椎、右前臂远端1/3处及全身骨密度呈负相关(rs分别为 0.352, 0.279, 0.344, 0.289及 0.394,均P0.05),校正年龄、脂肪量、BMI后,chemerin与全髋关节、全身骨密度的相关性依然存在(rs分别为 0.273和 0.378,均P0.05);多元线性回归分析示chemerin和BMI可作为全身骨密度的独立预测因子。结论:GD患者骨密度的降低除了与过量甲状腺激素对全身和骨细胞直接和间接作用导致骨吸收增强有关外,可能还与chemerin水平增高对骨代谢的负性调控作用有关。
[Abstract]:Objective: to observe the changes of cytokine chemokine (chemerin) levels in primary hyperthyroidism patients with Graves disease (GD), and to explore the relationship between the level of chemokine (chemerin) and bone mineral density (BMD). Methods: one hundred and twenty patients with GD with a course of 3 months were randomly selected as GD group, and 60 healthy persons who were matched by sex and age at the same time were collected as normal control group. Chemerin, bone conversion marker type 1 collagen carboxyl terminal 尾 -specific sequence (尾 -CTX), N-terminal molecular osteocalcin N-MID-OT (N-MID-osteocalcinin-N-MID-OT), bone mineral density (BMD), chemerin, 尾 -CTX and N-MID-OT were measured by Elisa. Bone mineral density (BMD) was measured by dual energy X ray absorptiometry. Results compared with the normal control group, the weight, lean weight, fat index (fat mass), body mass index (BMI) and bone mineral density (BMD) of the patients in the group of 20% GD were lower than those in the control group. There was a positive correlation between these factors (all P0.05). The level of chemerin in GD group was higher than that in the control group (P0.05). There was a positive correlation between 尾 -CTX and N-MID-OT (rs = 0.456 and 0.541respectively, P0.05), and a negative correlation with FMI and BMI (rs = 0.285, 0.281, 0.275, respectively). The level of chemerin in GD group was correlated with femoral neck, total hip joint and lumbar vertebrae. The bone mineral density (BMD) of 1 / 3 / 3 of the distal right forearm was negatively correlated with that of the whole body (rs = 0.352, 0.279, 0.344, 0.289 and 0.394, respectively, P0.05). Multiple linear regression analysis showed that chemerin and BMD could be used as independent predictors of BMD. Conclusion the decrease of bone mineral density in patients with GD may be related not only to the direct and indirect effects of excessive thyroid hormone on bone resorption, but also to the negative regulation of bone metabolism by the increase of chemerin level.
【作者单位】：中南大学湘雅医院内分泌科;永州市中心医院内分泌科;
【基金】：湖南省自然科学基金(13JJ6011) 湖南省科技厅计划项目(2010FJ4243)~~
【分类号】：R581.1

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