亚临床甲亢与老年男性椎体骨折风险增加的关系  

Relationship between subclinical hyperthyroidism and increased risk of vertebral fracture in elderly men

作　　者：张雅琴 宋敏 陈秀霞 ZHANG Ya-qin;SONG Min;CHEN Xiu-xia(Model Worker Health Management Center,Beijing Rehabilitation Hospital of Capital Medical University,Beijing 100144,China)

机构地区：[1]首都医科大学附属北京康复医院劳模健康管理中心,北京100144

出　　处：《颈腰痛杂志》2024年第2期291-295,共5页The Journal of Cervicodynia and Lumbodynia

基　　金：首都医科大学附属北京康复医院重大民生项目(编号:2018103)。

摘　　要：目的探讨亚临床甲亢(subclinical hyperthyroidism,SH)与老年男性椎体骨折风险增加的关系。方法选择2018年1月~2022年6月于该院健康体检时确诊为SH的老年男性患者120例作为研究组,按1:2比例抽取同期在该院健康体检时甲状腺功能正常的240例老年男性受试者作为对照组。通过电话随访受试者椎体骨折发生率,去除混杂因素后,观察SH与椎体骨折发生率的关系。结果360例受试者经电话随访,发生椎体骨折73例,其中研究组发生椎体骨折34例,发生率28.33%;对照组发生椎体骨折39例,发生率16.25%。研究组椎体骨折发生率高于对照组,差异有统计学意义(P<0.05)。椎体骨折和非椎体骨折受试者在促甲状腺素(thyroid stimulating hormone,TSH)、血清游离四碘甲状腺原氨酸(free tetraiodothyronine,FT4)、年龄、吸烟、骨折家族史、脆性骨折史、糖尿病、高血压、脑血管疾病、肾脏疾病、骨密度、日照时间、体育锻炼、补充维生素D、补钙、应用糖皮质激素、使用抗亚临床甲亢(subclinical hyperthyroidism,SH)药物等方面的资料比较,差异均存在统计学意义(P<0.05)。多因素Logistic回归分析显示,去除混杂因素后,SH是老年男性椎体骨折的风险因素(P<0.05),但TSH、FT4未显示出对椎体骨折的独立影响(P>0.05)。结论SH与老年人群椎体骨折风险增加相关。Objective To investigate the relationship between subclinical hyperthyroidism(SH)and the increased risk of vertebral fracture in elderly men.Methods A total of 120 elderly male SH patients diagnosed during physical examination in Beijing Rehabilitation Hospital of Capital Medical University were selected from January 2018 to June 2022 were selected as the study group,and 240 elderly male subjects with normal thyroid function during physical examination in our hospital in the same period were selected as the control group according to the ratio of 1∶2.The incidence of vertebral fracture was followed up by telephone to observe the relationship between SH and the incidence of vertebral fracture after removing confounding factors.Results There were 73 cases of vertebral fracture in 360 subjects who were followed up by telephone.Among them,34 cases of vertebral fracture occurred in the study group,with an incidence of 28.33%;in the control group,there were 39 cases of vertebral fracture,and the incidence was 16.25%.The incidence of vertebral fracture in the study group was significantly higher than that in the control group(P<0.05).There were significant differences in TSH,FT4,age,smoking,family history of fracture,history of fragile fracture,diabetes,hypertension,cerebrovascular disease,physical exercise,vitamin D supplement,calcium supplement,glucocorticoid application,anti SH drugs between subjects with vertebral fracture and non-vertebral fracture(P<0.05).Multivariate logistic analysis showed that SH was a risk factor for vertebral fracture after removing confounding factors(P<0.05),but TSH and FT4 did not show an independent effect on vertebral fracture(P>0.05).Conclusion Subclinical hyperthyroidism is associated with an increased risk of vertebral fracture in the elderly.

关 键 词：亚临床甲亢 椎体骨折 老年人群 

分 类 号：R683.2[医药卫生—骨科学]