Lee M S, Kim S Y, Lee M C, Cho B Y, Lee H K, Koh C S, Min H K
Department of Internal Medicine, Seoul National University College of Medicine, Korea.
J Clin Endocrinol Metab. 1990 Mar;70(3):766-70. doi: 10.1210/jcem-70-3-766.
To assess the changes in bone mineral density and osteoblastic activity in patients with hyperthyroidism and to investigate the relationship between those changes, we measured bone mineral density and serum osteocalcin in 109 patients with Graves' disease, comprising 75 untreated patients and 34 patients under treatment, and 200 normal controls. The degree of change in bone mineral density was quantified with Z transformation, in which we used means and SDs of bone mineral densities obtained in the process of age- and sex-matched 1:1 pairing developed by ourselves. Bone mineral density was low in female patients with hyperthyroidism in the spine, femur neck, trochanter, and Ward's triangle, but was not low in male patients. Serum osteocalcin was elevated in patients with untreated Graves' disease and correlated negatively with the Z values of bone mineral densities of the spine, femur neck, and trochanter. In conclusion, indices of osteoblastic activity were elevated in patients with hyperthyroidism, probably secondary to a thyroid hormone-induced increase in bone resorption which resulted in reduced bone mineral density. Quantification of the change in bone mineral density by using the parameters derived in the process of age- and sex-matched pairing seems to be an efficient method for statistical analyses.
为评估甲状腺功能亢进症患者的骨密度和成骨细胞活性变化，并研究这些变化之间的关系，我们对109例格雷夫斯病患者（包括75例未经治疗的患者和34例正在接受治疗的患者）以及200例正常对照者进行了骨密度和血清骨钙素测量。骨密度变化程度通过Z转换进行量化，其中我们使用了通过自行建立的年龄和性别匹配1:1配对过程中获得的骨密度均值和标准差。甲状腺功能亢进症女性患者在脊柱、股骨颈、大转子和沃德三角区的骨密度较低，但男性患者的骨密度并不低。未经治疗的格雷夫斯病患者血清骨钙素升高，且与脊柱、股骨颈和大转子骨密度的Z值呈负相关。总之，甲状腺功能亢进症患者的成骨细胞活性指标升高，可能继发于甲状腺激素诱导的骨吸收增加，导致骨密度降低。使用年龄和性别匹配配对过程中得出的参数对骨密度变化进行量化似乎是一种有效的统计分析方法。
