Pooran Nakechand, Singh Pankaj, Bank Simmy
Division of Gastroenterology Albert Einstein College of Medicine - Long Island Jewish Medical Center, New Hyde Park, NY 11040, USA.
World J Gastroenterol. 2003 Mar;9(3):615-8. doi: 10.3748/wjg.v9.i3.615.
To assess the role of thyroid disease as a risk for fractures in Crohn's patients.
A cross-sectional study was conducted from 1998 to 2000. The study group consisted of 210 patients with Crohn's disease. A group of 206 patients without inflammatory bowel disease served as controls. Primary outcome was thyroid disorder. Secondary outcomes included use of steroids, immunosuppressive medications, surgery and incidence of fracture.
The prevalence of hyperthyroidism was similar in both groups. However, the prevalence of hypothyroidism was lower in Crohn's patients (3.8 % vs 8.2 %, P=0.05). Within the Crohn's group, the use of immunosuppressive agents (0 % vs 11 %), steroid usage (12.5 % vs 37 %), small bowel surgery (12.5 % vs 28 %) and large bowel surgery (12.5 % vs 27 %) were lower in the hypothyroid subset as compared to the euthyroid subset. Seven (3.4 %) Crohn's patients suffered fracture, all of whom were euthyroid.
Thyroid disorder was not found to be associated with Crohn's disease and was not found to increase the risk for fractures. Therefore, screening for thyroid disease is not a necessary component in the management of Crohn's disease.
评估甲状腺疾病作为克罗恩病患者骨折风险因素的作用。
于1998年至2000年进行了一项横断面研究。研究组由210例克罗恩病患者组成。一组206例无炎症性肠病的患者作为对照。主要结局为甲状腺疾病。次要结局包括类固醇、免疫抑制药物的使用、手术及骨折发生率。
两组甲状腺功能亢进的患病率相似。然而，克罗恩病患者甲状腺功能减退的患病率较低（3.8%对8.2%，P = 0.05）。在克罗恩病组中，与甲状腺功能正常的亚组相比，甲状腺功能减退亚组免疫抑制剂的使用（0%对11%）、类固醇的使用（12.5%对37%）、小肠手术（12.5%对28%）和大肠手术（12.5%对27%）均较低。7例（3.4%）克罗恩病患者发生骨折，所有患者甲状腺功能均正常。
未发现甲状腺疾病与克罗恩病相关，也未发现其增加骨折风险。因此，甲状腺疾病筛查并非克罗恩病管理的必要组成部分。
