绝经后女性促甲状腺激素生理变异对骨密度和骨质疏松症的影响研究

发布时间：2018-08-15 17:15

【摘要】：目的探讨甲状腺功能正常的绝经后女性促甲状腺激素(TSH)水平参考范围内的波动对骨密度、骨质疏松症的影响。方法选取2009年11月—2010年2月参与贵阳市社区居民健康调查的甲状腺功能正常的绝经后女性234例为研究对象。检测受试者甲状腺功能、维生素D、甲状旁腺激素(iPTH)、血钙、血磷水平;采用双能X线骨密度仪测量左侧股骨颈、L1~4、全髋、大转子、ward三角区骨密度。根据TSH水平,以三分位数将受试者分为3组,即Q1组(0.73~2.67 mU/L)、Q2组(2.68~3.83 mU/L)、Q3组(3.84~6.14 mU/L),各78例。结果各组股骨颈、全髋、大转子、ward三角区骨密度及股骨颈骨密度T值比较,差异均有统计学意义(P0.05);其中,Q2组大转子骨密度高于Q1组,Q3组股骨颈、全髋、ward三角区骨密度高于Q1组,Q3组股骨颈骨密度T值高于Q1、Q2组(P0.05)。TSH水平与股骨颈、全髋、ward三角区骨密度呈正相关(r=0.17、0.14、0.16,P0.05)。多元线性回归分析显示,校正年龄、绝经年限、BMI、维生素D、iPTH后,TSH水平与股骨颈骨密度(b=0.012,b'=0.134)、wards三角区骨密度(b=0.013,b'=0.125)独立相关(P0.05)。各组股骨颈骨量减少检出率比较,差异有统计学意义(P0.05);其中,Q3组股骨颈骨量减少检出率低于Q1组、Q2组(P0.016)。结论甲状腺功能正常的绝经后女性TSH水平参考范围内波动可能会对股骨颈、全髋、ward三角区骨密度产生一定的影响,并且TSH水平可能是股骨颈、ward三角区骨密度的独立影响因素,低TSH水平者有更高的骨量减少发生率。
[Abstract]:Objective to investigate the effect of the fluctuation of thyroid stimulating hormone (TSH) level in postmenopausal women with normal thyroid function on bone mineral density (BMD) and osteoporosis. Methods 234 postmenopausal women with normal thyroid function were selected from November 2009 to February 2010. Thyroid function, vitamin D, serum calcium and phosphorus levels of parathyroid hormone (iPTH), were measured by dual energy X-ray absorptiometry. Bone mineral density of left femoral neck, total hip and trochanter trigonometry were measured by dual energy X-ray absorptiometry. According to the level of TSH, the subjects were divided into three groups, Q1 group (0.73 卤2.67 mU/L), Q2 group (2.68 卤3.83 mU/L) and Q3 group (3.846.14 mU/L). Results there were significant differences in bone mineral density (BMD) of femoral neck, total hip, trochanter trigonometry and femoral neck (P0.05), in which the greater trochanter density in Q2 group was higher than that in Q1 group, and the femoral neck in Q3 group was higher than that in Q1 group. The bone mineral density (BMD) of femoral neck in the total hip ward triangle area was higher than that in Q1 group and Q3 group (P0.05). TSH level was positively correlated with femoral neck bone density (r = 0.17) 0.140.16 (P 0.05). Multiple linear regression analysis showed that the corrected age, menopausal age, and the level of TSH after vitamin D / iPTH were independently correlated with the bone mineral density (BMD) of femoral neck (BV 0.012) and the bone mineral density (BMD) of the triangle area (BV 0.013) (P 0.05). The positive rate of femoral neck bone reduction was significantly lower in Q3 group than that in Q1 group (P0.016). Conclusion the fluctuation of TSH level in postmenopausal women with normal thyroid function may have an effect on bone mineral density of femoral neck and total hip ward triangle, and TSH level may be an independent influencing factor of bone mineral density in femoral neck ward triangle. Lower TSH levels had a higher incidence of bone mass reduction.
【作者单位】：三二0一医院内分泌科;贵州医科大学附属医院内分泌代谢病科;
【基金】：贵州省科技厅社会攻关计划[黔科合LG字(2011)016]——血清25羟维生素D水平与糖代谢紊乱的相关性研究贵州省优秀科技教育人才省长专项资金项目(黔省专合字[2010]82号)——贵阳市健康成人维生素D营养状况与骨代谢的相关性研究
【分类号】：R580

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