中年男性2型糖尿病血清促甲状腺激素对骨代谢影响研究  

Effects of thyroid stimulating hormone on bone metabolism in middle-aged patients with type 2 diabetes

作　　者：袁虎[1] 程晓芸[2] 杨蓬[2] 吴国亭[2] 曲伸[2] 盛春君[2] 

机构地区：[1]苏州市立医院东区内分泌科,江苏苏州215001 [2]上海市第十人民医院内分泌科,上海200072

出　　处：《中国实用内科杂志》2013年第1期46-48,共3页Chinese Journal of Practical Internal Medicine

基　　金：国家自然科学基金(81070238)

摘　　要：目的探讨血清促甲状腺激素(TSH)对新诊断中年男性2型糖尿病的患者骨密度的影响。方法选取2010年1月至2011年3月上海市第十人民医院内分泌科就诊的中年男性2型糖尿病患者35例,测定甲状腺激素系列、骨代谢等指标;采用双能X线吸收骨密度仪测定腰椎(L1～L4)、髋部(股骨颈、大转子、转子间区、髋部总体及Ward's区)骨密度。按照TSH水平,将研究对象平均分为体重指数(BMI)相匹配的2组,即低TSH组(17例)和高TSH组(18例)进行比较分析。结果 (1)低TSH组中,有4例骨密度正常、8例骨量减少和5例骨质疏松,而在高TSH组中,有5例骨量正常,13例骨量减少。(2)高TSH组腰椎以及髋部骨密度均高于低TSH组,其中以股骨颈最明显。(3)低TSH组的Ⅰ型胶原显著高于高TSH组。(4)TSH水平与Ⅰ型胶原负相关(r=-0.536,P=0.007)。结论 TSH可以抑制骨的吸收,减少骨量流失,正常范围内的高TSH具有一定骨保护作用。Objective To investigate the effects of thyroid stimulating hormone （TSH） on bone mineral density （BMD） in middle-aged males with newly diagnosed type 2 diabetes. Methods Between January 2010 and March 2011,35 middle- aged males with newly diagnosed type 2 diabetes who had normal serum TSH levels were recruited from the department of endocrinology, the Tenth People＇s Hospital of Shanghai for measurement of thyroid hormone and bone metabolism indices. Furthermore, dual-energy X-ray absorptiometry （DEXA） was employed to detect lumbar （ Lj - L4 ） , bone mineral density （BMD） of femur （femoral neck, trochanter major, Intertrochanter region and Wards＇s region）. Based on serum TSH levels, the subjects were further allocaed to low TSH group （n = 17 ） and high TSH group （n = 18 ） matching with body mass index （BMI） for subsequent statistical analysis. Results （ 1 ） In low TSH group, normal BMD was found in 4 cases, decreased bone mass in 8 cases and osteoporosis in 5 cases. While in high TSH group, normal bone mass was found in 5 cases and de- creased bone mass in 13 cases. （2）The high TSH group had higher L1 - L4 and BMD of hip （Neck, Troch, Inter, Total, Ward＇s region）. Notably,the neck of femur was most obvious. （3）The type [ collagen in low TSH group was significantly higher than that in high TSH group. （4）The serum TSH level was negatively correlated with type I collagen （r = -0. 536, P = 0. 007 ）. Conclusion TSH has bone protective effects by inhibition of bone absorption and reduction of the loss of bone

关 键 词：男性骨质疏松 促甲状腺激素 骨吸收 2型糖尿病 

分 类 号：R681[医药卫生—骨科学]