绝经后2型糖尿病患者亚临床甲状腺功能减退症与骨质疏松症的相关性研究

The research of correlation between subclinical hypothyroidism and osteoporosis in postmenopausal women with type 2 diabetes The research of correlation between subclinical hypothyroidism and osteoporosis in postmenopausal women with type 2 diabetes

目的探讨绝经后2型糖尿病患者亚临床甲状腺功能减退症（SCH）与骨质疏松症的相关性。方法选取绝经后2型糖尿病患者193例，其中甲状腺功能正常者128例（NTF组），SCH组65例。比较两组患者一般情况及生化指标的差异，分析SCH与骨质疏松症的相关性。结果（1）SCH组患者的左髋骨密度明显低于NTF组，差异有统计学意义（P〈0．05）；（2）在单因素相关分析中，促甲状腺激素与总胆固醇（Tc）、血磷呈正相关，与空腹血糖（FPG）、骨钙素（BGP）呈负相关（P〈0．05）；（3）Logistic回归分析结果显示，骨质疏松症与血清促甲状腺激素（TSH）呈正相关（OR=7．008，95％CI：1．333-36．834，P〈0．05），在排除其他危险因素后，高TSH仍是骨质疏松症的独立危险因素。结论绝经后2型糖尿病患者合并SCH时，更易导致骨密度降低，发生骨质疏松。

Objective To investigate the correlation between subclinical hypothyroidism（SCH） and osteoporosis in postmenopausal women with type 2 diabetes. Methods 193 cases of postmenopausal women with type 2 diabetes were selected from Endocrinology Department of our hospital, including 128 cases of normal thyroid function and 65 cases of SCH. Then the general conditions and biochemical indexes of the two groups were compared and the relationship between SCH and osteoporosis was analyzed. Results （1）The left hip BMD of SCH group were lower than that of normal thyroid function group （P 〈 0.05）. （ 2 ） In the simple correlation analysis, thyrotropin （ TSH ） and cholesterol （ TC ） blood phosphorus were positively correlated respectively, and negatively correlated with FPG and BGP（ P 〈 0.05 ）. （3） Osteoporosis and TSH were positively correlated in the postmenopausal women with type 2 diabetes （OR = 7. 008,95 % CI：1. 333- 36. 834,P 〈 0.05 ） , and high level of TSH was an independent risk factor for osteoporosis after the adjustment of other risk factors. Conclusion Postmenopausal women with type 2 diabetes are more likely to induce the decrease of bone mineral density even osteoporosis when they develop SCH.