甲亢患者骨代谢的特点研究

Study on Characteristics of Bone Metabolism in Patients with Hyperthyroidism

目的 探讨甲状腺功能对骨代谢的影响。方法 测定 40例甲亢患者及 40例健康对照者的 型胶原交联羧基末端肽 (ICTP)、血清 型前胶原羧基末端前肽 (PICP)、骨钙素 (OSC)、甲状旁腺素 (PTH)以及骨代谢相关指标。结果 甲亢患者破骨细胞功能指标 (血清 ICTP)和成骨活性指标 (血清 PICP和 OSC)水平均明显高于对照组 (P<0 .0 0 1) ,两组甲状旁腺功能 (PTH)水平正常 ,差别无统计学意义。甲亢患者 ICTP与 PICP,与 FT3 、FT4分别存在显著正相关。结论 甲亢患者破骨细胞功能增强伴成骨细胞活性增加 ,无继发性甲状旁腺功能改变。甲亢时骨转换加速可能与甲状腺激素直接参与有关 。

Objective To investigate the effects of thyroid function on bonemetabolism.Methods Biochemical markers of bone metabolism such as carboxy terminal cross linked telopeptide of type Ⅰ collage (ICTP),osteocalin(OSC),parathyroid hormone (PTH) and other markers related to bone metabolism were respectively measured in 40 patients with hyperthyroidism and 40 normal subjects.Results The levels of bond resorption marker(ICTP) and bond formation markers(PICP and OSC) in experimental group were both significantly higher than those in normal subjects(P<0.001).The levels of PTH showed no significant difference between two groups(P>0.05).Significant positive correlations were found between ICTP and PICP, and between ICTP and FT 3 and FT 4 in patients with hyperthyroidism.Conclusion Patients with hyperthyroidism were characterized by increased function of bone resorption accompanied by increased activity of bone formation and by no secondary functional change of parathyroid.Thyroid hormone might speed up bone turnover directly,thus resulting in bone mass lose mainly by the process of bone resorption.