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甲状腺功能亢进患者硬骨素与骨代谢的关系

张梦媛,任安   

  1. 安徽医科大学附属省立医院内分泌科
  • 收稿日期:2013-12-24 修回日期:2014-05-19 出版日期:2014-09-15 发布日期:2014-09-15
  • 通讯作者: 张梦媛

The Relationship between Sclerostin and Bone Metabolism in Hyperthyroidism Patients

ZHANG Mengyuan , ren an   

  1. Department of Endocrinology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei230001, China
  • Received:2013-12-24 Revised:2014-05-19 Published:2014-09-15 Online:2014-09-15
  • Contact: ZHANG Mengyuan

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摘要：

?【摘要】目的 比较甲状腺功能亢进（甲亢）患者和健康人群血清硬骨素（SOST）水平，研究甲亢患者SOST与骨代谢相关指标及骨密度（BMD）的关系。方法? 收集60例甲亢患者作为甲亢组，同时选取甲状腺功能正常的30例健康体检者作为对照组；依据BMD T值将甲亢患者分为骨密度正常组和骨量减少/骨质疏松组。肘正中静脉采血检测所有受试者甲状腺功能和SOST，同时检测甲亢患者甲状腺相关抗体，甲状旁腺激素（PTH）、N-MID骨钙素（NMID）、总1型胶原氨基端延长肽（tP1NP）、β-胶原特殊序列（β-CTX）；双能X线吸收仪（DEXA）测量桡骨、股骨颈及腰椎的BMD。结果?? （1）甲亢组血清SOST水平高于对照组（P＜0.01）。（2）甲亢患者中，骨量减少/骨质疏松组的 SOST、N-MID、tP1NP、β-CTX、游离甲状腺素（FT4）显著高于骨密度正常组，PTH显著低于骨密度正常组（P＜0.05）。（3）甲亢患者SOST与游离三碘甲状腺原氨酸（FT3）、β-CTX呈正相关（rs分别为0.380、0.296, P＜0.05），与PTH、桡骨全部BMD、股骨颈BMD、腰椎BMD呈负相关（rs分别为-0.485、-0.322、-0.266、-0.455，P＜0.05）。结论 甲亢患者血清SOST水平升高，其可能与甲亢患者骨代谢异常的发生有关。

关键词: 硬骨素, 甲状腺功能亢进, 骨代谢, 骨质疏松

Abstract: Objective To compare the differences between serum sclerostin levels in hyperthyroidism patients and euthyroidism healthy people. To explore the relationship between sclerostin levels and bone metabolism markers, BMD in hyperthyroidism patients. Methods Analyze sclerostin levels in 60 hyperthyroidism patients and 30 euthyroidism healthy people. 60 hyperthyroidism patients were divided into groups according to the T-score of their BMD. The bone metabolism markers and BMD were measured and the correlation between sclerostin and them was analyzed. Results The sclerostin levels in the hyperthyroidism group were higher than that in the euthyroid group(P＜0.01) . Among hyperthyroidism patients, the group with osteopenia or osteoporosis had a higher sclerostin, N-MID osteocalcin, total of type 1 collagen amino terminal extension of the peptide (tP1NP), beta collagen special sequence (P＜0.05) and a lower parathyroid hormone (PTH) (P＜0.05) compared to normal BMD group. Sclerostin was positively correlated with free triiodothyronine（FT3）and beta collagen special sequence and negatively correlated with PTH, total radius BMD, femoral neck BMD and lumber spine BMD in hyperthyroidism patients. Conclution Hyperthyroidism patients had a higher serum sclerostin levels, sclerostin is closely associated with abnormalities of bone metabolism.

Key words: Sclerostin, Hyperthyroidism, Bone metabolism, Osteoporosis