老年人甲状腺激素与骨代谢变化的临床研究

Clinical study of thyroid hormones and bone turnover in the elderly

目的 观察甲状腺激素 (TH)水平对老年人骨代谢指标变化的影响。方法 健康老人 40例作为治疗组 ,选择健康老人 30例作为正常对照组及甲亢老人 2 8例作为甲亢对照组。治疗组每日服甲状腺片 1 0 mg,连服 6个月。所有受试者均检测 FT3、FT4 血清钙 (Ca) ,碱性磷酸酶(ALP) ,骨钙素 (BGP)及尿羟脯氨酸 /肌酐 (Hop/ Cr)。结果 甲亢对照组血清 Ca、ALP、BGP及 Hop/ Cr明显高于正常对照组 ,与 FT3、FT4 水平呈正相关 ;治疗组经小剂量 TH治疗后 ,可使血清 TH水平升高 ,但骨代谢指标 Ca、AL P、BGP及 Hop/ Cr改变不显著 ,与 FT3、FT4 水平呈零相关。结论 过量 TH(如甲亢 )可使骨代谢指标升高 ,而小剂量 TH的补充治疗可升高血清中 TH水平 ,但对骨代谢指标无影响。

Objective To get the information about the effect of biochemical marks of bone turnover with various dose of thyroid hormones(TH) in older persons Methods 40 cases of healthy old person served as treatment group; 30 cases healthy old person as normal control group and 28 cases hyperthyroidism patients as hyperthyroid control group Treatment group: taking thyroid tablet 10 mg per day for 6 months FT 3, FT 4, serum calcium(Ca), alkaline phosphatase(ALP), bone glaprotein(BGP) and urine hydroproline/creatinine ratio(Hop/Cr) were measured respectively Results Serum Ca, ALP, BGP, and urine Hop/Cr of the hyperthyroid control group were remarkably higher than those of the normal control group The relation between biochemical marks of bone and the levels of FT 3, FT 4 were positive; the levels of TH were elevated after treatments with small dose of TH in treatment group But the changes of biochemical markes in bone turnover(Ca, ALP, BGP and Hop/Cr) were not distinct , and no relation with the levels of FT 3 or FT 4 either Conclusions The biochemical marks of bone turnover were elevated by overdose of TH (hyperthyroidism), however, the levels of TH were increased by small dose of TH in supplemental therapy, but there is no influence in the biochemical marks of bone turnover