引用本文:胡映玉,颜晓东,玉颜庆.Graves病患者骨质疏松的相关影响因素分析[J].中国临床新医学,2018,11(12):1199-1201.
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Graves病患者骨质疏松的相关影响因素分析
胡映玉,颜晓东,玉颜庆
530021 南宁,广西壮族自治区人民医院内分泌代谢科
摘要:
[摘要] 目的 研究Graves病(GD)继发骨质疏松患者的生化指标的变化,为寻找Graves病继发骨质疏松的预测因子提供信息支持。方法 收集141例GD患者,其中29例患者伴有骨量降低,归为低骨量组;112例患者骨密度(BMD)正常,归为对照组。检测所有患者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)、25-羟维生素D(25-OHD)、甲状腺受体抗体(TRAb)、血清碱性磷酸酶(ALP)、血清总Ⅰ型前胶原N末端肽(PINP)、血清β-胶原C末端肽(β-CTX)水平以及腰椎(L1-L4)、股骨颈(FN)、桡骨远端(DR)的BMD。结果 低骨量组患者TSH、TRAb、25-OHD、BMD水平较对照组显著降低(P<0.01),FT3、FT4、ALP、PINP、β-CTX水平显著高于对照组(P<0.05)。GD患者骨代谢标志物PINP、β-CTX与LS、FN、DR的BMD均呈负相关(P<0.05)。结论 GD患者BMD的降低与血清骨代谢标志物升高相关。监测骨代谢标志物水平可预测骨量的变化,有助于早期发现GD继发性骨质疏松患者。
关键词:  Graves病  骨质疏松  骨代谢标志物
DOI:10.3969/j.issn.1674-3806.2018.12.06
分类号:R 581.1
基金项目:广西卫计委科研课题(编号:Z2012285)
Analysis of the factors associated with osteoporosis in Graves disease patients
HU Ying-yu, YAN Xiao-dong, YU Yan-qing
Department of Endocrinology, the People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
Abstract:
[Abstract] Objective To study the changes of biochemical indexes in the patients with secondary osteoporosis of Graves disease(GD) and to provide the information for finding the predictors of the disease. Methods 141 patients with GD were included in this study. They were divided into osteopenia group(with bone loss, n=29) and control group[with normal bone mineral density(BMD), n=112] according to different bone densities. BMDs of the lumber spine(L1-L4), femoral neck(FN) and distal radius(DR) were measured using dual-energy X-ray absorptiometry. The levels of serum free triiodothyronine(FT3), free thyroxine(FT4), thyroid-stimulating hormone(TSH), 25-hydroxyvitamin D(25-OHD), thyrotropin receptor antibodies(TRAb), alkaline phosphatase(ALP), aminoterminal prepeptide typeⅠ procollagen(PINP), β cross-linked C-telopeptide of type 1 collagen(β-CTX)were detected in all the patients. Results The levels of TSH, TRAb, 25-OHD and BMD in the osteopenia group were significantly lower than those in the control group(P<0.01). The levels of FT3, FT4, ALP, PINP and β-CTX in the osteoporosis group were significantly higher than those in the control group(P<0.05). Markers of bone metabolism PINP and β-CTX in the GD patients were negatively correlated with BMD at the LS, FN and DR(P<0.05). Conclusion The decrease of BMD is associated with the increase of serum bone metabolism markers in GD patients. Monitoring the levels of bone metabolic markers can predict the changes of bone mass, which is helpful for early detection of secondary osteoporosis of GD.
Key words:  Graves disease  Osteoporosis  Markers of bone metabolism