甲状腺功能亢进症患者尿脱氧吡啶啉的变化

Changes of Urinary Dexyobidinine in Hyperthyroid Patients

目的 研究甲状腺功能亢进症 (甲亢 )患者新的骨代谢指标的变化。方法 测定 44例甲亢患者及 3 8例健康对照者的血清钙、磷、总碱性磷酸酶 (ALP)、骨钙素 (OC)、尿脱氧吡啶啉 (DPD)的水平。结果 甲亢组除血钙 (2 .40 3± 0 .189vs 2 .40 0± 0 .12 9,P =0 .0 7)与对照组无明显差别外 ,血磷 (1.2 5± 0 .0 9vs 1.12± 0 .0 6,P <0 .0 1)、ALP(10 0 .2 5± 12 .64vs 5 3 .5 5± 8.5 8,P <0 .0 1)、OC(13 .0 7± 3 .0 9vs 6.2 4± 1.5 7,P <0 .0 1)和尿DPD(3 1.62 3± 4.87vs 4.63 4± 0 .945 ,P <0 .0 1)均较对照组有明显增高。骨形成指标OC、ALP分别增高 110 %、87% ,而骨吸收指标尿DPD增高 62 8% ,以尿DPD活性增高更为显著 ,尿DPD与患者年龄、病程不相关。血ALP与T4呈正相关 ,尿DPD、血OC与T3 呈正相关。结论 甲亢患者由于高水平甲状腺激素的作用骨代谢增强 ,骨吸收大于骨形成 ;

Objective To study the changes of new index of bone metabolic in hyperthyroid patients.Method The levels of serum calcium,phosphate,total serum alkaline phosphatase(ALP),osteocalcin(OC) and urinary dexyobidinine(DPD) were measured respectively in 44 hyperthyroid patients and 38 healthy controls.Results There was no significant difference in the levels of serum calcium between the patients and controls( P =0.07).The concentration of serum phosphate,ALP,OC and urinary DPD in the patients were significantly higher than those in controls( P<0.01,P<0.01,P <0.01 respectively).DPD were not significantly related to age and course,while serum ALP was positive related to T 4,urinary DPD and serum OC were also positive related to T 3.For serum ALP, OC and DPD, hyperthyroid patients showed a statistically significant increase of about 87%,110% and 628% respectively.Conclusions Hyperthyroid patients have higher bone metabolism resulting from high level thyroid hormones and accelerated bone loss is higher than accelerated bone formation.DPD is a sensitive and specific biochemical index of bone absorption.