初诊甲亢患者骨密度和骨代谢标记物的变化

摘要

Objective To investigate the changes of bone mineral density and bone metabolism marker in newly diagnosed hyperthyroidism patients. Methods There were 32 patients with hyperthyroidism as hyperthyroidism group, and another 30 healthy people as control group. Detection was taken for serum alkaline phosphatase (ALP), calcium (Ca2+), free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), serum osteocalcin (N-MID),β-collagen special sequence (β-CTx), total procollagen type Ⅰ amino-terminal propeptide (tP1NP), and femoral neck bone mineral density (BMD) for comparative analysis. Results The hyperthyroidism group had much higher serum ALP, Ca2+, FT3, FT4,β-CTx, N-MID, tP1NP and lower TSH than control group, and their differences had statistical signficance (P<0.05);and its femoral neck BMD was lower than the control group (P<0.05). tP1NP,β-CTx, and N-MID were respectively in positive correlation with FT3 and FT4, and in negative correlation with TSH (P<0.05). N-MID and femoral neck BMD had negative correlation (P<0.05). Conclusion Bone metabolism markers of formation and resorption were all increased in newly diagnosed hyperthyroidism patients. They had lost bone mass, and easily had high conversion osteoporosis.%目的：初步探讨初诊甲状腺功能亢进症(甲亢)患者骨密度和骨代谢生化指标的变化。方法32例甲亢患者作为甲亢组，另选取30例健康体检者作为对照组，测定两组血清碱性磷酸酶(ALP)、钙(Ca2+)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、血清N-端骨钙素(N-MID)、β-胶原特殊序列(β-CTx)以及总Ⅰ型前胶原氨基端延长肽(tP1NP)及股骨颈骨密度(BMD)，并进行比较分析。结果甲亢组患者血清ALP、Ca2+、FT3、FT4、β-CTx、N-MID、tP1NP较对照组明显升高， TSH明显降低，差异均具有统计学意义(P<0.05)；甲亢组较正常对照组股骨颈BMD明显降低(P<0.05)；tP1NP、β-CTx、N-MID分别与FT3、FT4呈正相关，和TSH负相关(P<0.05)；N-MID和股骨颈BMD呈负相关(P<0.05)。结论初诊甲亢患者骨形成和骨吸收标记物均升高，骨量丢失，易出现高转换型骨质疏松。