Abstract：Objective: To analyze the correlation between thyroid stimulating hormone (TSH) and lumbar and hip bone density in postmenopausal type 2 diabetes mellitus (T2DM) patients with normal thyroid function. Methods: A retrospective selection of 82 menopausal women admitted to the Department of Endocrinology in our hospital from May 2018 to May 2019 were made the research subjects. The subjects' fasting venous blood was collected,and biochemical indexes,thyroid function and bone metabolism indexes were measured; dual-energy X-ray bone density meter was used to measure the bone mineral density of the lumbar spine and total hip. Based on the median of TSH,TSH<2.59μIU/mL was regarded as low TSH group,and TSH≥2.59μIU/mL was regarded as high TSH group,with 41 cases in each. The differences of various indicators between the two groups were compared and their correlation with bone mineral density was analyzed. Results: Comparison of FBG,HbA1c,TC,HDL-C and LDL-C showed no significant difference in age,T2DM course,BMI,glucose and lipid metabolism index in the two groups (P>0.05). TSH level in the low TSH group was significantly lower than that in the high TSH group. There were no significant differences in the bone metabolism indexes of calcium,phosphorus and ALP between the two groups (P>0.05),but the levels of PINP and β-CTx in the low TSH group were significantly higher than those in the high TSH group (P<0.05). Comparison of bone mineral density between the two groups showed that T values of lumbar vertebral bone density and hip bone density in the low TSH group were significantly higher than those in the high TSH group (P<0.05). Pearson analysis showed that TSH was negatively correlated with PINP,β-CTx and r was -0.294 and -0.264,respectively (P<0.05). TSH was positively correlated with lumbar bone density and hip bone density T,and r was 0.617 and 0.410,respectively (P<0.05). Conclusion: In postmenopausal T2DM women with normal thyroid function,TSH level is negatively correlated with bone metabolism indexes PINP and β-CTx,while it is positively correlated with lumbar vertebral bone density and hip bone density T value.
张苏皖, 戴武, 叶军, 章容, 曹永红. 甲状腺功能正常的绝经后T2DM患者腰椎及髋部骨密度与促甲状腺素的关系研究[J]. 河北医学, 2021, 27(3): 410-414.
ZHANG Suwan, DAI Wu, YE Jun, et al. The Relationship Between Lumbar and Hip Bone Density and Thyrotropin in Postmenopausal T2DM Patients with Normal Thyroid Function. HeBei Med, 2021, 27(3): 410-414.
[1] Wildawati R,Anggreny Y,Putri D K.Determinan pencegahan osteoporosis pada Wanita menopause[J]. Jurnal Ners Indonesia,2020,10(2):229. [2] Claire G.Shared variants for osteoporosis and T2DM[J]. Nature Reviews Endocrinology,2018,14(11):627. [3] Delitala A P,Scuteri A,Doria C.Thyroid hormone diseases and osteoporosis[J]. Journal of Clinical Medicine,2020,9(4):1034. [4] Cannarella R,Barbagallo F,Condorelli R A,et al.Osteoporosis from an endocrine perspective:the role of hormonal changes in the elderly[J]. Journal of Clinical Medicine,2019,8(10):1564. [5] 赵宗权,吴贻红,汤振源,等.老年骨质疏松症流行病学调查及预防措施研究[J].中国骨质疏松杂志,2019,25(7):994~997. [6] Segna D,Bauer D C,Feller M,et al.Association between subclinical thyroid dysfunction and change in bone mineral density in prospective cohorts[J].Other,2018,283(1):56~72. [7] 姜国良,王萍.甲状腺功能减退对妊娠妇女骨代谢及骨密度的影响[J].安徽医药,2018,22(6):1109~1111. [8] Janen O E,Bullmann C.Thyroid and Bone[J]. Der nuklearmediziner,2019,42(3):241~244. [9] 许雅娟,张淼,张婧喆,等.妊娠期糖尿病患者孕晚期肠道菌群的变化[J].郑州大学学报(医学版),2020,55(3):441~444. [10] 岳建彪,苟静,魏翾娣,等.鲑鱼降钙素注射液与唑来膦酸注射液对绝经后骨质疏松症患者骨转换标志物水平及骨密度的影响[J].河北医学,2019,25(11):1777~1781. [11] Vliet N A,Noordam R,Klinken J B,et al.Thyroid stimulating hormone and bone mineral density:Evidence from a two-sample Mendelian randomization study and a candidate gene association study[J]. Journal of Bone & Mineral Research,2018,33(7):1318~1325.
2021, Vol. 27 
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