兰州市社区居民亚临床甲状腺功能减退症患者骨密度变化及影响因素

Changes of bone mineral density and its influencing factors in subclinical hypothyroidism of community residents in Lanzhou

目的分析亚临床甲状腺功能减退症患者骨密度的变化及影响因素,探讨该人群的骨质疏松状况。方法纳入符合亚临床甲状腺功能减退症标准的患者216例(亚临床甲减组),按性别、绝经情况分层,同时纳入与其年龄和性别相匹配的非亚临床甲减被调查者228例(对照组)。测量并比较两组间的一般指标、甲状腺功能指标、骨代谢指标及左前臂和右跟骨的骨密度情况;Pearson相关分析法分析亚临床甲减患者各指标和骨密度之间的相关性;多元线性回归分析探索亚临床甲减患者骨质疏松的主要影响因素。结果亚临床甲减组促甲状腺素水平远高于对照组;左前臂及右跟骨BMD均低于对照组,差异均有统计学意义(P<0.05)。亚临床甲减组左前臂和右跟骨骨质疏松患病率分别为19.91%和17.59%,均高于相应对照组的13.16%和9.65%,且差异均有统计学意义(P<0.05)。Pearson相关分析显示,亚临床甲减患者左前臂及右跟骨骨密度均与促甲状腺素呈负相关。多元线性回归分析的结果提示,促甲状腺素是影响亚临床甲减患者骨密度的主要因素之一。结论亚临床甲状腺功能减退患者存在骨密度降低,其骨密度与促甲状腺素水平密切相关。

Objective To analyze the changes and influencing factors of bone mineral density(BMD)in patients with subclinical hypothyroidism,and to explore the osteoporosis status of this population.Methods 216 cases of subclinical hypothyroidism(subclinical hypothyroidism group)were included,stratified by gender and menopause,and 228 non subclinical hypothyroidism patients matched with their age and gender(control group).The general index,thyroid function index,bone metabolism index and bone density of left forearm and right calcaneus were measured and compared between the two groups;Pearson correlation analysis was used to analyze the correlation between bone density and each index in subclinical hypothyroidism;Multiple linear regression analysis was used to explore the main influencing factors of osteoporosis in subclinical hypothyroidism.Results The level of thyrotropin in subclinical hypothyroidism group was much higher than that in the control group,and the BMD of left forearm and right calcaneus were lower than that in the control group(P<0.05).The prevalence of osteoporosis in the subclinical hypothyroidism group was 19.91%and 17.59%respectively,which were higher than that in the corresponding control group(13.16%and 9.65%,respectively),and the difference was statistically significant(P<0.05).Pearson correlation analysis display that the BMD of left forearm and right calcaneus in subclinical hypothyroidism was negatively correlated with TSH.The result of multiple linear regression analysis showed that thyrotropin was one of the main factors influencing bone mineral density in subclinical hypothyroidism patients.Conclusion Patients with subclinical hypothyroidism have decreased bone mineral density,which is closely related to the level of thyroid stimulating hormone.