女性甲状腺疾病患者骨密度变化及影响因素分析  

Changes and influencing factors of bone mineral density in female patients with thyroid disease

作　　者：陈伟银 黄汉超 CHEN Wei-yin;HUANG Han-chao(Guangdong Second Traditional Chinese Medicine Hospital(Guangdong Institute of Traditional Chinese Medicine Engineering and Technology),Guangzhou 510095,China)

机构地区：[1]广东省第二中医院(广东省中医药工程技术研究院)、广州中医药大学第五临床医学院,510095

出　　处：《中国实用医药》2024年第9期48-52,共5页China Practical Medicine

摘　　要：目的 分析女性甲状腺疾病患者骨密度变化情况及其影响因素。方法 选取112例女性甲状腺疾病患者,检测患者骨密度情况并依据相关标准分为减少组(68例)与正常组(44例)。经单因素、多因素分析导致女性甲状腺疾病患者骨密度变化的影响因素。结果 112例女性甲状腺疾病患者中发生骨量减少56例,发生骨质疏松12例,骨密度减少总计68例(减少组),占比为60.71%(68/112);骨量正常44例(正常组),占比为39.29%(44/112)。减少组合并糖尿病占比38.24%、绝经占比51.47%、血清促甲状腺激素(TSH)(5.36±0.52)mIU/L、血清碱性磷酸酶(ALP)(149.27±13.81)U/L、血清成纤维细胞生长因子23(FGF23)(103.84±9.58)ng/L高于正常组的18.18%、27.27%、(4.95±0.51)mIU/L、(133.75±12.32)U/L、(97.67±7.68)ng/L,差异有统计学意义(P<0.05)。两组年龄、体质量指数(BMI)、文化程度、居住地、吸烟史、饮酒史、高血压、高脂血症、血清超敏C反应蛋白(hs-CRP)水平、血清白蛋白(ALB)水平比较,差异无统计学意义(P>0.05)。经单项Logistic回归分析,结果显示,合并糖尿病、绝经、血清TSH水平高、血清ALP水平高、血清FGF23水平高均是女性甲状腺疾病患者骨密度减少的危险因素(OR=2.786、2.828、4.570、1.093、1.083)。经多元Logistic回归分析,结果显示,合并糖尿病、绝经、血清TSH水平高、血清ALP水平高、血清FGF23水平高均是女性甲状腺疾病患者骨密度减少的独立危险因素(OR=4.463、4.145、4.255、1.100、1.109)。结论 女性甲状腺疾病患者骨密度减少的影响因素可能与合并糖尿病,绝经,血清TSH、ALP、FGF23水平高等因素有关。Objective To analyze the changes of bone mineral density in female patients with thyroid disease and its influencing factors.Methods 112 female patients with thyroid diseases were selected,and the bone mineral density of the patients was detected and divided into the reduced group(68 cases)and normal group(44 cases)according to the relevant standards.The influencing factors leading to changes in bone mineral density of female patients with thyroid disease were analyzed by unifactorial and multifactorial analysis.Results Among the 112 female patients with thyroid disease,osteopenia occurred in 56 cases,osteoporosis in 12 cases,with a total of 68 cases of reduced bone mineral density(reduced group),accounting for 60.71%(68/112);there were 44 cases of normal bone mass(normal group),accounting for 39.29%(44/112).In the reduced group,the percentage of combined diabetes was 38.24%,the percentage of menopause was 51.47%,the serum thyroidstimulating hormone(TSH)was(5.36±0.52)mIU/L,the serum alkaline phosphatase(ALP)was(149.27±13.81)U/L,and the serum fibroblast growth factor 23(FGF23)was(103.84±9.58)ng/L,which were higher than 18.18%,27.27%,(4.95±0.51)mIU/L,(133.75±12.32)U/L,and(97.67±7.68)ng/L in the normal group,and the difference was statistically significant(P<0.05).There was no significant difference in comparison of age,body mass index(BMI),education level,place of residence,smoking history,drinking history,hypertension,hyperlipidemia,serum hypersensitive C-reactive protein(hs-CRP)level and serum serum albumin(ALB)level between the two groups(P>0.05).Single Logistic regression analysis showed that diabetes mellitus,menopause,high serum TSH level,high serum ALP level and high serum FGF23 level were all risk factors for reduced bone mineral density in female patients with thyroid disease(OR=2.786,2.828,4.570,1.093,1.083).Multivariate Logistic regression analysis showed that diabetes,menopause,high serum TSH level,high serum ALP level and high serum FGF23 level were independent risk factors for reduced bone miner

关 键 词：甲状腺疾病 骨密度 糖尿病 促甲状腺激素 

分 类 号：R581[医药卫生—内分泌]