甲亢患者骨钙素和甲功、骨密度及脂代谢指标相关性研究  

The correlation of osteocalcin with thyroid function, bone density and lipid metabolism in hyperthyroidism patients

作　　者：靳晓萍[1] 韩莉[1] 詹先琴 王新玲[1] 王燕[1] JIN Xiaoping;HAN Li;ZHAN Xianqin;WANG Xinling;WANG Yan(Department of Endocrinology, Xinjiang Uyghur Autonomous Region People′s Hospital, Urumqi 830001, China)

机构地区：[1]新疆维吾尔自治区人民医院内分泌科,乌鲁木齐830001

出　　处：《新疆医科大学学报》2019年第5期638-642,共5页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区人民医院院内项目(20130220)

摘　　要：目的观察在以高代谢为主的住院甲状腺功能亢进症(甲亢)患者中,骨钙素和甲状腺功能(甲功)、骨密度及脂代谢指标的相关性。方法回顾性分析88例住院甲亢患者的甲功及抗体,甲状旁腺激素(PTH)、维生素D(25-OH-D)、骨钙素、脂代谢指标、尿碘、和中轴骨骨密度等指标,行Spearman等级相关性分析。结果血清骨钙素水平和总三碘甲状腺原氨酸(TT_3)、游离三碘甲状腺原氨酸(FT_3)、总甲状腺素(TT_4)、游离甲状腺素(FT_4)及促甲状腺激素受体抗体(TRAb)正相关,r值分别为0.428、0.458、0.352、0.357及0.250(P<0.05);血清骨钙素水平与股骨颈、Ward三角、全腰椎骨密度、全髋骨密度负相关,r值分别为-0.227、-0.260、-0.246和-0.294(P<0.05);血清骨钙素水平与体质指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、腹围(WC)负相关,r值分别为-0.211、-0.224、-0.228和-0.341(P<0.05);碘过量和碘超足量患者共40例,占45.5%;维生素D缺乏患者82例,占93.2%。结论骨可能通过骨钙素参与甲亢患者的脂代谢,降低中轴骨的骨密度,TRAb可作为骨代谢变化的有效监控指标之一,同时监测尿碘、减少碘的摄入,补充维生素D,对维护甲亢患者的骨骼、肌肉健康非常重要。Objective To observe the correlations of serum osteocalcin(OC) with the thyroid function, bone mineral density(BMD) and lipid level in hyperthyroidism patients with hyper-conversion. Methods Data of thyroid hormone function and related antibodies, parathyroid hormone, 25-OH-D, OC, urine iodine, and central BMD, waist circumference(WC), body mass index(BMI), Total cholesterol(TC), et al, were collected. All data were analyzed by spearman rank correlation. Results OC was positive related with TT3, FT3, TT4, FT4, TRAb(Thyroid-stimulating hormone receptor antibody), and r were 0.428, 0.458, 0.352, 0.357, 0.250, respectively(P<0.05). OC was negative related with BMD of femoral neck, ward triangle, total lumber, total hip, and r were-0.227,-0.260,-0.246,-0.294, respectively(P<0.05). OC was negative related with BMI, TC, Triglyceride(TG), WC, and r were-0.211,-0.224,-0.228,-0.341, respectively(P<0.05). Iodine excess and iodine over enough group was 45.5%, and vitamin D deficiency was 93.2% in hyperthyroid patients. Conclusion Bone may participate in the lipid metabolism of hyperthyroidism patients through osteocalcin to reduce the bone density of the central axis bone. TRAb can be used as one of the effective monitoring indicators of bone metabolism changes. Meanwhile, the monitoring of urinary iodine, the reduction of iodine intake and vitamin D supplementation are very important for maintaining the bone and muscle health of hyperthyroidism patients.

关 键 词：甲状腺功能亢进症 骨钙素 骨密度 脂代谢 促甲状腺素受体抗体 

分 类 号：R581.1[医药卫生—内分泌]