中国全科医学2017，Vol.20Issue(8)：907-911,5.DOI:10.3969/j.issn.1007-9572.2017.08.004
绝经后女性促甲状腺激素生理变异对骨密度和骨质疏松症的影响研究
Effect of Physiological Variations of Thyroid Stimulating Hormone on Bone Mineral Density and Osteoporosis in Postmenopausal Women
摘要
Abstract
Objective To investigate the effect of the fluctuation of thyroid stimulating hormone (TSH) level in the normal range on the bone mineral density (BMD) and osteoporosis of postmenopausal women with normal thyroid function.Methods 234 postmenopausal women with normal thyroid function who participated in the health survey of community residents in Guiyang from November 2009 to February 2010 were selected as the research objects.The thyroid function,vitamin D,parathyroid hormone (iPTH),serum calcium,and serum phosphorus levels of the subjects were detected;the BMD of left femoral neck,L1-4,total hip,greater trochanter,and ward triangle were measured by dual energy X-ray bone sonometers.According to the TSH level,subjects were divided into 3 groups by tri-sectional quantile method:group Q1 (0.73-2.67 mU/L),groupQ2 (2.68-3.83 mU/L),groupQ3 (3.84-6.14 mU/L),78 cases in each group.Results The BMD of the femoral neck,total hip,greater trochanter,and ward triangle,and the T value of the BMD of the femoral neck in these groups were significantly different (P ＜0.05).The BMD of greater trochanter in group Q2 was higher than that in group Q1,the BMD of the femoral neck,total hip,and ward triangle in group Q3 was higher than that in group Q1,and the T value of the BMD of the femoral neck in group Q3 was higher than that in group Q1 and Q2 (P ＜ 0.05).There was a positive correlation between the TSH level and BMD of femoral neck,total hip and ward triangle (r =0.17,0.14,0.16,P ＜ 0.05).Multivariate linear regression analysis showed that TSH level and the BMD of femoral neck (b =0.012,b'=0.134) and ward triangle (b =0.013,b'=0.125) were independently related after correcting age,menopausal years,BMI,vitamin D and iPTH,(P ＜0.05).There was significant difference in the detection rate of osteopenia in femoral neck (P ＜ 0.05).Among them,the detection rate of osteopenia in femoral neck in group Q3 was lower than that in group Q1 and Q2 (P ＜0.016).Conclusion The physiological variation of THS level of postmenopausal women with normal thyroid function may have certain effect on BMD of the femoral neck,total hip,and ward triangle.Moreover,the TSH level may be the independent influencing factor of femoral neck and ward triangle,and low level of TSH is associated with a higher incidence of osteopenia.关键词
骨质疏松,绝经后/促甲状腺激素/骨密度Key words
Osteoporosis/postmenopausal/Thyroid-stimulating hormone/Bone density分类
医药卫生引用本文复制引用
王佳丹,张巧,时立新,彭年春,张淼..绝经后女性促甲状腺激素生理变异对骨密度和骨质疏松症的影响研究[J].中国全科医学,2017,20(8):907-911,5.基金项目
贵州省科技厅社会攻关计划[黔科合LG字(2011)016]——血清25羟维生素D水平与糖代谢紊乱的相关性研究 （2011）
贵州省优秀科技教育人才省长专项资金项目(黔省专合字[2010] 82号)——贵阳市健康成人维生素D营养状况与骨代谢的相关性研究 （黔省专合字[2010] 82号）
