Molecular Endocrinology Group, Department of Medicine and MRC Clinical Sciences Centre, Imperial College London, London W12 0NN, UK.
Arch Biochem Biophys. 2010 Nov 1;503(1):129-36. doi: 10.1016/j.abb.2010.06.021. Epub 2010 Jun 23.
The hypothalamic-pituitary-thyroid axis plays a key role in skeletal development, acquisition of peak bone mass and regulation of adult bone turnover. Euthyroid status is essential for maintenance of optimal bone mineralization and strength. In population studies, hypothyroidism and hyperthyroidism have both been associated with an increased risk of fracture. Furthermore, recent studies in healthy euthyroid post-menopausal women indicate that thyroid status in the upper normal range is also associated with low bone mineral density and an increased risk of non-vertebral fracture. Studies in mutant mice have demonstrated that thyroid hormone receptor α is the major mediator of T3 action in bone and that thyroid hormones exert anabolic actions during growth but have catabolic effects on the adult skeleton. Nevertheless, TSH has also been proposed to be a direct negative regulator of bone turnover, although the relative importance of T3 and TSH actions in the skeleton has yet to be clarified.
下丘脑-垂体-甲状腺轴在骨骼发育、获得峰值骨量和调节成人骨代谢中发挥着关键作用。甲状腺功能正常对于维持最佳的骨矿化和强度是必要的。在人群研究中，甲状腺功能减退症和甲状腺功能亢进症都与骨折风险增加有关。此外，最近对健康的绝经后甲状腺功能正常的女性的研究表明，甲状腺功能处于正常范围的上限也与低骨密度和非椎体骨折风险增加有关。在突变小鼠的研究中已经证明，甲状腺激素受体α是 T3 在骨骼中作用的主要介导者，并且甲状腺激素在生长过程中发挥合成代谢作用，但对成年骨骼有分解代谢作用。然而，促甲状腺激素也被提议是骨转换的直接负调节剂，尽管 T3 和 TSH 作用在骨骼中的相对重要性尚未阐明。
