甲状腺功能异常对男性骨密度影响的研究

Study on the effect of bone mineral density in males with abnormal thyroid function

目的探讨甲状腺功能异常对50~80岁男性骨密度的影响,为这类患者的骨质疏松症防治提供理论基础。方法纳入162名50~80岁男性,根据甲状腺功能分为正常对照组(90名),甲亢组(38例),甲减组(34例)。检测记录三组受试者血清FT3、FT4、TSH、Ca、P、1,25-(OH)2D3、ALP以及BGP水平。测量三组受试者正位腰椎1~4与左侧髋关节骨密度。结果甲减组血清FT3、FT4、ALP、BGP水平低于对照组(P<0.05),而甲亢组高于对照组(P<0.05);甲减组血清TSH高于对照组(P<0.05),而甲亢组低于对照组(P<0.05);甲亢及甲减组腰椎和髋关节BMD低于对照组(P<0.05)。三组受试者血清Ca、P、1,25-(OH)2D3差异无统计学意义(P>0.05)。相关性结果表明血清BGP和ALP与FT3、FT4间存在统计学正相关,与TSH呈负相关(P<0.05);骨密度T值评分与FT3、FT4间存在统计学负相关(P<0.05)。Logistic回归结果显示甲减和甲亢均对骨密度有负向影响(P<0.05)。结论甲状腺功能异常对50~80岁男性骨密度有负面影响,应重视甲状腺功能异常患者骨密度的改变,这对于骨质疏松症的防治具有重要意义。

Objective To investigate the effect of bone density in 50-80 years old males with abnormal thyroid function.In order to provide the theoretical basis for the prevention and treatment of osteoporosis in these patients.Methods 162 males aged 50 to 80 years old were included and divided into normal control group(90 cases),hyperthyroidism group(38 cases)and hypothyroidism group(34 cases)according to thyroid function.The levels of serum FT3,FT4,Ca,P,1,25-(OH)2D3,ALP and BGP were recorded.BMD of the lumbar spine 1-4(L1-4)and the left femoral neck were measured in the three groups of subjects.Results The serum levels of FT3,FT4,ALP and BGP in hypothyroidism group were lower than those in control group(P<0.05),and serum levels in hyperthyroidism group were higher than those in control group(P<0.05).Serum TSH in hypothyroidism group was higher than that in control group(P<0.05),and serum TSH in hyperthyroidism group was lower than that in control group(P<0.05).BMD of lumbar spine and the left femoral neck in hyperthyroidism and hypothyroidism group was lower than that in control group(P<0.05).There was no significant difference in serum Ca,P,1,25-(OH)2D3 among the three groups(P>0.05).The correlation showed that serum ALP and BGP were positively correlated with FT3 and FT4,and negatively correlated with TSH(P<0.05),The T-score shows negative correlated with FT3 and FT4(P<0.05).Logistic regression analysis showed that both hypothyroidism and hypothyroidism had negative effects on bone mineral density(P<0.05).Conclusion Abnormal thyroid function has a negative effect on bone density in males,and the change of bone density in patients with abnormal thyroid function should be paid attention to,which has great significance for the prevention and treatment of osteoporosis in males.