老年亚临床甲减患者骨代谢生化指标的变化

Changes of Serum Bone Metabolic Biochemical Markers in ElderlySubjects with Subclinical Hypothyroidism

目的:测定老年亚临床甲减患者骨代谢生化指标及探讨其临床意义。方法:采用放射免疫分析与电 化学发光免疫分析法观察了30例老年亚临床甲减患者,30例老年健康人S-BGP、TSH和FT4水平,同时观察 了两组血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、 载脂蛋白A1(ApoA1)、载脂蛋白B100(ApoB100)以及钙离子(Ca2+)的浓度变化。结果:①30例老年亚临床甲减 患者S-BGP浓度为(2.78±0.96)μg/L,30例老年健康人S-BGP浓度为(3.9±1.48)μg/L。两组比较差异 非常显著(P<0.01)。②30例老年亚临床甲减患者血清Ca2+浓度为(2.16±0.17)mmol/L,30例老年健康人 血清Ca2+浓度为(2.31±0.21)mmol/L,两组比较差异非常显著(P<0.01)。③30例老年亚临床甲减患者TC 和LDL-C水平分别为(5.58±0.41)mmol/L和(3.67±0.36)mmol/L,与老年健康组比较差异非常显著(P< 0.01)。结论:由于Ca2+浓度的降低,导致骨丢失,S-BGP浓度降低可能是老年亚临床甲减患者骨质疏松的主 要原因。

Objective To explore the clinical significance of changes of serum bone metabolic biochemical markers levels in elderly subjects with subclinical hypothyoridism. Methods Serum S-BGP (with RIA), TSH, FT 4 (with ECLIA), total cholesterol (TC), triglyceride (TG), HDL, LDL, ApoA 1, ApoB and Ca 2+ (with biochemical methods) were measured in 30 elderly subjects with subclinical hypothyroidism and 30 controls. Results The serum levels of S-BGP and calcium in elderly subjects with subclinical hypothyroidsm (2.78±0.96μg/L and 2.16±0.17mmol/L respectively) were significantly lower than those in controls (3.9±1.48μg/L and 2.31±0.21mmol/L respectively, both P<0.01). TC and LDL levels in the subclinical hypothyroid subjects (5.58±0.41mmol/L and 3.67±0.36mmol/L) were significantly higher than those in controls (P<0.01). Conclusion The lowering of calcium levels in subjects with subclinical hypothyroidism would lead to loss of bone mass. Decreased S-BGP contents might be the chief cause of osteoporosis in these subjects.