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| Correlation Between Bone Metabolism Indicators and Thyroid Hormones in Patients with Hyperthyroidism and Predictive Value on Hyperthyroidism Osteoporosis |
| MA Xingpo, NIU Min, SHEN Jinfu, et al |
| Fuyang People's Hospital, Anhui Fuyang 236000, China |
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Abstract Objective: To observe the changes of bone metabolism in patients with hyperthyroidism and their relationship with thyroid hormones and hyperthyroid osteoporosis. Methods: 176 patients with hyperthyroidism who were admitted from September 2017 to September 2020 were selected as hyperthyroidism group, and 100 healthy controls were selected as control group. The thyroid hormones [total triiodothyronine (TT3), free triiodothyronine (FT3), total thyroxine (TT4), free thyroxine (FT4), thyroid-stimulating hormone (TSH)] and bone metabolism indexes [25-hydroxyvitamin D [25-(OH)-D], total aminoterminal propeptide of type I procollagen (TPINP), β-Crosslaps (β-CTX), N-terminal osteocalcin (N-MID)] were compared between the two groups. Pearson correlation analysis was used to analyze the correlation between bone metabolism indexes and thyroid hormones. Bone mineral density (BMD) was used to evaluate whether hyperthyroidism were complicated with osteoporosis. Based on this, the patients were divided into osteoporosis group and non-osteoporosis group. The differences of the above bone metabolism indexes were compared between the two groups, and receiver operating characteristic (ROC) curve was plotted to analyze the predictive value of bone metabolism indexes on hyperthyroid osteoporosis. Results: The levels of serum TT3, FT3, TT4 and FT4 in hyperthyroidism group were significantly higher than those in control group (P<0.05), while the TSH level was significantly lower than that in control group (P<0.05). The 25-(OH)-D level was significantly lower than that in control group (P<0.05), while the levels of TPINP, β-CTX and N-MID were significantly higher than those in control group (P<0.05). Serum 25-(OH)-D in patients with hyperthyroidism was negatively correlated with TT3, FT3, TT4 and FT4 (P<0.05). TPINP was positively correlated with FT3 and FT4 (P<0.05). β-CTX was positively correlated with TT3, FT3, TT4 and FT4 (P<0.05), and was negatively correlated with TSH (P<0.05). N-MID was positively correlated with TT3, FT3, TT4 and FT4 (P<0.05), and was negatively correlated with TSH (P<0.05). The detection rate of osteoporosis among 176 patients with hyperthyroidism was 23.30% (41 cases). The level of 25-(OH)-D in osteoporosis group was significantly lower than that in non-osteoporosis group (P<0.05), while the levels of TPINP, β-CTX and N-MID were significantly higher than those in non-osteoporosis group (P<0.05). The areas under the ROC curves (AUC) of 25-(OH)-D, TPINP, β-CTX and N-MID in predicting hyperthyroid osteoporosis were 0.660, 0.721, 0.641 and 0.639 (P<0.05), and the AUC of the combination of the four was 0.786 (P<0.05). Conclusion: Serum 25-(OH)-D of patients with hyperthyroidism is abnormally decreased, while TPINP, β-CTX and N-MID are abnormally increased, and the above indexes are closely related to the levels of thyroid hormones. The combined detection of 25-(OH)-D, TPINP, β-CTX and N-MID has a certain predictive value on hyperthyroid osteoporosis.
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2021, Vol. 27 
