Hisa Itoko, Kaji Hiroshi, Inoue Yoshifumi, Sugimoto Toshitsugu, Chihara Kazuo
Int J Clin Exp Med. 2008;1(4):319-26. Epub 2008 Sep 22.
How glucose levels affect bone in patients with primary hyperparathyroidism is unknown, although the prevalence of impaired glucose metabolism is higher in patients with primary hyperparathyroidism. The present study was performed to examine the relationships between fasting plasma glucose (FPG) and various indices in 93 postmenopausal women with primary hyperparathyroidism. Bone mineral density (BMD) and body composition were measured by dual-energy Xray absorptiometry. Body weight, body mass index (BMI), fat mass and % fat were positively related to FPG. Serum levels of calcium and parathyroid hormone (PTH) as well as bone metabolic indices were not related to FPG and immunoreactive insulin levels. As for BMD, FPG was positively related to the Z scores of BMD at the lumbar spine and femoral neck, although it was not significantly related to the Z-score of BMD at the radius. On the other hand, immunoreactive insulin levels were not significantly related to BMD parameters at any sites. In multiple regression analysis, FPG was significantly related to BMD (Z score) at the lumbar spine and femoral neck, when body weight, BMI, immunoreactive insulin, PTH, and bone resorption indices were considered; however, these relationships at the lumbar spine were not significant when fat mass was considered. In conclusion, the present study indicated that FPG levels were positively related to BMD at the lumbar spine and femoral neck in postmenopausal women with primary hyperparathyroidism.
尽管原发性甲状旁腺功能亢进症患者糖代谢受损的患病率较高,但血糖水平如何影响原发性甲状旁腺功能亢进症患者的骨骼尚不清楚。本研究旨在探讨93例绝经后原发性甲状旁腺功能亢进症女性的空腹血糖(FPG)与各项指标之间的关系。采用双能X线吸收法测量骨密度(BMD)和身体成分。体重、体重指数(BMI)、脂肪量和脂肪百分比与FPG呈正相关。血清钙、甲状旁腺激素(PTH)水平以及骨代谢指标与FPG和免疫反应性胰岛素水平无关。至于骨密度,FPG与腰椎和股骨颈骨密度的Z值呈正相关,尽管它与桡骨骨密度的Z值无显著相关性。另一方面,免疫反应性胰岛素水平与任何部位的骨密度参数均无显著相关性。在多元回归分析中,当考虑体重、BMI、免疫反应性胰岛素、PTH和骨吸收指标时,FPG与腰椎和股骨颈的骨密度(Z值)显著相关;然而,当考虑脂肪量时,腰椎的这些关系并不显著。总之,本研究表明,原发性甲状旁腺功能亢进症绝经后女性的FPG水平与腰椎和股骨颈的骨密度呈正相关。