甲状腺功能亢进症患儿经抗甲状腺药物治疗后的皮质骨密度正常化。
Normalization of cortical bone density in children and adolescents with hyperthyroidism treated with antithyroid medication.
机构信息
Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA 90027, USA.
出版信息
Osteoporos Int. 2012 Sep;23(9):2277-82. doi: 10.1007/s00198-011-1867-8. Epub 2011 Dec 21.
UNLABELLED
We assessed bone size and bone density (BD) measurements using computed tomography (CT) in children and adolescents with hyperthyroidism treated with antithyroid medication. We found that cortical BD appeared to improve at 1 year and normalize at 2 years in all tested patients.
INTRODUCTION
Our previous study demonstrated that cortical BD in children and adolescents with untreated hyperthyroidism was significantly decreased as compared to age-, sex- and ethnicity-matched healthy controls. The present report evaluated whether attainment of euthyroidism by medical antithyroid treatment was able to improve or normalize cortical BD in these patients.
METHODS
Anthropometrics and three-dimensional CT bone measurements including cross-sectional area (CSA), cortical bone area (CBA) and cortical BD at midshaft of the femur (cortical bone), and CSA and BD of L(1) to L(3) vertebrae (cancellous bone) in 15 children and adolescents after 1- and 2-year treatments with antithyroid medication were reviewed and compared to their pretreatment results.
RESULTS
All patients were euthyroid at 1 and 2 years after medical antithyroid treatment. After adjusting for age, height, weight and Tanner stage, a significant increase in cortical BD in all patients (15/15) was found after 1 year of treatment (P < 0.001). Normalization of cortical BD was demonstrated in all tested patients (10/15) after 2 years. There were no significant changes in the other cancellous or cortical bone parameters.
CONCLUSION
Cortical BD was improved at 1 year and normalized at 2 years in hyperthyroid patients rendered euthyroid with antithyroid medication.
目的
使用计算机断层扫描（CT）评估患有甲状腺功能亢进症并接受抗甲状腺药物治疗的儿童和青少年的骨大小和骨密度（BD）测量值。我们发现，所有接受测试的患者的皮质 BD 在 1 年后似乎有所改善，在 2 年后恢复正常。
引言
我们之前的研究表明，与年龄、性别和种族匹配的健康对照组相比，未经治疗的甲状腺功能亢进症儿童和青少年的皮质 BD 明显降低。本报告评估了通过医学抗甲状腺治疗实现甲状腺功能正常是否能够改善或使这些患者的皮质 BD 恢复正常。
方法
对 15 名接受抗甲状腺药物治疗 1 年和 2 年后的儿童和青少年的人体测量学和三维 CT 骨骼测量值（包括股骨中段的横截面积（CSA）、皮质骨面积（CBA）和皮质 BD（皮质骨）以及 L1 至 L3 椎体的 CSA 和 BD（松质骨））进行回顾，并与治疗前结果进行比较。
结果
所有患者在接受抗甲状腺药物治疗 1 年和 2 年后均处于甲状腺功能正常状态。在调整年龄、身高、体重和 Tanner 阶段后，所有患者（15/15）的皮质 BD 在治疗 1 年后显著增加（P < 0.001）。所有接受测试的患者（10/15）在 2 年后皮质 BD 恢复正常。其他松质骨或皮质骨参数没有明显变化。
结论
接受抗甲状腺药物治疗后甲状腺功能正常的甲状腺功能亢进症患者的皮质 BD 在 1 年内得到改善，并在 2 年内恢复正常。
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