甲状腺功能亢进症治疗前后血清护骨素水平的变化及与骨密度和骨转换指标的关系

Association of serum osteoprotegerin levels with bone mineral density and bone turnover markers in patients with hyperthyroidism before and after methimazole treatment

对62例甲状腺功能亢进症（甲亢）患者于治疗前后测定血清护骨素水平及血清骨碱性磷酸酶、骨钙素、Ⅰ型胶原交联C端肽的变化，以及第2～4腰椎正位、股骨颈、Ward三角、大粗隆的骨密度。甲亢患者骨密度显著低于正常水平，骨转换指标均显著高于正常水平，治疗后上述指标均明显好转；血清护骨素水平显著高于正常水平，治疗后明显下降，血清护骨素水平与骨密度和骨转换指标有相关性，血清护骨素水平可反映甲亢患者的骨代谢异常。

Serum bone alkaline phosphatase （BAP）, osteocalcin （OC）, C-telopeptides of type-1 collagen （CTx）, osteoprotegerin （OPG） levels, and bone mineral density （BMD） were evaluated in 62 hyperthyroid patients and 60 healthy subjects matched for sex and age. In hyperthyroid patients, the biochemical evaluations and bone density were performed before and after 6 months of methimazole （MMI） treatment. Results showed that the BMD in lumbar spine L2 - L4, neck of femur, Ward＇s triangle and greater trochanter of patients before treatment were all significantly lower than those in healthy controls, and improved markedly after MMI treatment. The serum bone turnover parameters BAP, OC and CTx in patients before treatment were all significantly higher than those in control group, and were decreased markedly after treatment. The serum OPG level in patients with hyperthyroidism was significantly higher than that in healthy controls, and decreased markedly after treatment. The serum OPG levels were significantly correlated with bone turnover parameters （BAP, OC, CTx） and BMD, which indicates that serum OPG level can reflect the abnormality of bone metabolism in patients with hyperthyroidism.