Jamal Sophie A, Leiter Richard E, Bayoumi Ahmed M, Bauer Douglas C, Cummings Steven R
Department of Medicine, Division of Endocrinology and Metabolism, St Michael's Hospital, University of Toronto, 61 Queen Street East, Toronto, Ontario M5C 2T2, Canada.
Osteoporos Int. 2005 May;16(5):534-40. doi: 10.1007/s00198-004-1718-y. Epub 2004 Aug 31.
Clinicians regularly order laboratory tests in women with osteoporosis to assess if an underlying medical condition is contributing to bone loss. To determine which laboratory tests are associated with osteoporosis we conducted a secondary analyses of data collected as part of the Fracture Intervention Trial (FIT), which included 15,316 postmenopausal women. Women had tests of liver and kidney function, mineral metabolism, electrolytes and complete blood count, femoral neck and total body BMD and spinal radiographs. The prevalence of abnormal tests in women with osteoporosis compared to women without was not different, except for low TSH (<0.5 IU/ml). Among women with and without osteoporosis at the femoral neck the prevalence of low TSH was 4.9% (95% CI: 4.4-5.5) and 3.7% (95% CI: 3.3-4.1), respectively, yielding a positive likelihood ratio of 1.2 (95% CI: 1.1-1.3). We observed similar results for women with vertebral fractures compared to women without vertebral fractures; positive likelihood ratio of 1.4 (95% CI: 1.3-1.6). Our data suggests that when assessing healthy women with osteoporosis ordering a routine panel of laboratory tests is not useful but measuring TSH may be informative.
临床医生经常对患有骨质疏松症的女性进行实验室检查，以评估是否存在某种潜在的疾病导致骨质流失。为了确定哪些实验室检查与骨质疏松症相关，我们对作为骨折干预试验（FIT）一部分收集的数据进行了二次分析，该试验纳入了15316名绝经后女性。这些女性接受了肝功能、肾功能、矿物质代谢、电解质和全血细胞计数检查，以及股骨颈和全身骨密度测量和脊柱X光检查。与未患骨质疏松症的女性相比，患有骨质疏松症的女性异常检查的患病率并无差异，但促甲状腺激素水平低（<0.5 IU/ml）的情况除外。在股骨颈有和没有骨质疏松症的女性中，促甲状腺激素水平低的患病率分别为4.9%（95%可信区间：4.4 - 5.5）和3.7%（95%可信区间：3.3 - 4.1），阳性似然比为1.2（95%可信区间：1.1 - 1.3）。对于有椎体骨折和没有椎体骨折的女性，我们观察到了类似的结果；阳性似然比为1.4（95%可信区间：1.3 - 1.6）。我们的数据表明，在评估患有骨质疏松症的健康女性时，进行常规的实验室检查并无用处，但测量促甲状腺激素水平可能会提供有用信息。
