甲状腺疾病对绝经后女性骨量丢失的影响

Effect of thyroid disease on bone loss in postmenopausal women

目的探讨甲状腺疾病对自然绝经女性骨密度的影响。方法通过回顾性病例对照研究,选取甲状腺疾病(包括甲状腺功能亢进、减退、结节、瘤和癌)患者144例,按同年龄和体质量指数(BMI)匹配288例无甲状腺疾病者。运用SPSS 24.0进行统计分析。结果甲状腺疾病组和无甲状腺疾病组比较,年龄、绝经年龄、身高、体质量和BMI差异无统计学意义,初潮年龄、怀孕次数、哺乳次数差异存在统计学意义(P<0.01)。②甲状腺疾病组股骨颈、大转子和Ward区骨密度均显著低于无甲状腺疾病组(P<0.05或P<0.01),两组腰椎骨密度比较无差异。甲状腺疾病组的骨质疏松症患病率49.31%,显著高于无甲状腺疾病组39.24%(P<0.05),甲状腺疾病组的骨折发生率21.53%高于无甲状腺疾病组16.67%,但比较差异无统计学意义。③在甲状腺疾病类分组中,甲状腺结节组较其他甲状腺疾病组股骨颈骨密度低,甲状腺结节组显著低于甲亢组和甲状腺瘤组(P<0.05)。结论患有甲状腺疾病的绝经后女性具有股骨颈低骨密度的风险,而甲状腺结节患者较甲亢和甲状腺瘤患者股骨颈低骨密度风险更大。

Objective To discuss the effect of thyroid disease on bone mineral density in postmenopausal women.Methods Through retrospective case-control study,144 patients with thyroid diseases(including hyperthyroidism,hypothyroidism,thyroid nodules,tumors andcancer)were selected,and 288 patients without thyroid diseases were matched according to the same age and body mass index(BMI).SPSS 24.0 was used for statistical analysis.Results There were no significant differences in age,menopause age,height,body weight and BMI between the thyroid disease group and the group without thyroid disease.There were differences in age of menarche,number of pregnancies andlactation(P<0.01).②The BMD of femoral neck,greater trochanter and Ward's region in thyroid disease group was significantly lower than the no thyroid disease group(P<0.05 or P<0.01),and there was no difference in lumbar vertebrae BMD between the two groups.The prevalence rate of osteoporosis in the thyroid disease group was 49.31%higher than that in the group without thyroid disease(39.24%)(P<0.05),and the fracture rate in the thyroid disease group was 21.53%higher than that in the group without thyroid disease(16.67%),but there was nodifference.③Inthyroid disease group,the BMD of femoral neck in the thyroid nodule group was lower than the other thyroid disease groups,and the thyroid nodule group was significantly lower than that in the hyperthyroidism and thyroid tumor groups(P<0.05).Conclusion Postmenopausal women with thyroid disease are at risk for low BMD in the femoral neck,and patients with thyroid nodules are at greater risk for low BMD in the femoral neck than patients with hyperthyroidism and thyroid tumors.