脂联素基因多态性与分化型甲状腺癌术后TSH抑制治疗患者发生骨质疏松的相关性研究

Association of adiponectin gene polymorphism with osteoporosis in postoperative TSH suppression therapy patients with differentiated thyroid cancer

目的探讨脂联素基因多态性与分化型甲状腺癌(differentiated thyroid carcinoma,DTC)术后促甲状腺激素(thyroid stimulating hormone,TSH)抑制治疗患者发生骨质疏松的相关性。方法收集79例行甲状腺癌切除术且行TSH抑制治疗患者作为研究对象,随访5年后检测患者骨密度,将其分为骨量正常组与骨质疏松组。对比两组患者一般资料,分析rs1063539、rs266729、rs3774261、rs710445基因型在两组患者中的分布频率。分析rs1063539、rs266729、rs3774261、rs710445不同基因型分组患者的骨密度差异。探究DTC术后TSH抑制治疗患者发生骨质疏松的危险因素。结果一般资料分析结果显示两组患者骨质疏松家族史(P=0.021)与术前甲状腺激素状况(P=0.022)差异有统计学意义。rs1063539、rs266729、rs3774261、rs710445基因型频率偏差符合Hardy-Weinberg平衡定律。rs1063539位点的3种基因型在两组患者中分布差异有统计学意义,且rs1063539 CC+CG基因型的骨密度T值(-3.68±0.61)显著低于GG型(-3.14±0.47)(t=3.14,P=0.003)。Logistic回归分析,无骨质疏松家族史是甲状腺癌术后TSH抑制治疗患者发生骨质疏松的保护因素(OR:0.258,OR 95%CI:0.083~0.773,P=0.020),术前甲状腺激素亢进(OR:2.203,OR 95%CI:1.131~4.541,P=0.025)与rs1063539 CC+CG基因型(OR:4.392,OR 95%CI:1.248~17.652,P=0.027)是诱发骨质疏松的危险因素。结论脂联素rs1063539基因多态性与患者骨密度有相关性,rs1063539 CC+CG基因型能增加DTC术后TSH抑制治疗患者发生骨质疏松的风险。

Objective To investigate the correlation between adiponectin gene polymorphism and osteoporosis in patients with differentiated thyroid after thyroid stimulating hormone(thyroid stimulating hormone,TSH)suppression therapy.Methods A total of 79 patients who underwent resection of thyroid cancer and TSH suppression therapy were collected as research objects.After 5 years of follow-up,the bone mineral density of the patients was measured,and they were divided into normal bone mass group and osteoporosis group.The general data of the two groups of patients were compared,and the distribution frequencies of rs1063539,rs266729,rs3774261,and rs710445 genotypes in the two groups of patients were analyzed.The differences in bone mineral density of patients with different genotypes of rs1063539,rs266729,rs3774261,and rs710445 were analyzed.To explore the risk factors of osteoporosis in patients treated with TSH suppression after differentiated thyroid surgery.Results General data analysis showed that the family history of osteoporosis(P=0.021)and preoperative thyroid hormone status(P=0.022)were significantly different between the two groups(all P<0.05).The genotype frequency deviations of rs1063539,rs266729,rs3774261,and rs710445 conformed to the Hardy-Weinberg equilibrium law.The distribution of the three genotypes of rs1063539 locus was significantly different between the two groups,and the bone mineral density T value of rs1063539 CC+CG genotype(-3.68±0.61)was significantly lower than that of GG type(-3.14±0.47)(t=3.142,P=0.003).Logistic regression analysis showed that no family history of osteoporosis was a protective factor for osteoporosis in patients with TSH suppression after thyroid cancer surgery(OR:0.258,OR 95%CI:0.082-0.773,P=0.020).Preoperative hyperthyroidism(OR:2.203,OR 95%CI:1.134-4.541,P=0.025)and rs1063539 CC+CG genotype(OR:4.392,OR 95%CI:1.248-17.652,P=0.027)were the risk factors inducing osteoporosis.Conclusion Adiponectin rs1063539 gene polymorphism is associated with bone mineral density in patients,and rs1063539 CC+CG genotype can increase the risk of osteoporosis in patients treated with TSH suppression after differentiated thyroid surgery.