抗甲状腺治疗后Graves病患者骨密度和骨小梁评分的变化
Changes in bone mineral density and trabecular bone score in Graves' disease patients after anti-thyroid therapy.
作者信息
Ock So Young, Chung Yoon-Sok, Choi Yong Jun
机构信息
Department of Internal Medicine, Kosin University College of Medicine, Busan, Republic of Korea.
Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.
出版信息
Osteoporos Sarcopenia. 2016 Sep;2(3):175-179. doi: 10.1016/j.afos.2016.05.004. Epub 2016 Jun 21.
OBJECTIVE
The purpose of this study was to evaluate changes in bone quantity based on bone mineral density (BMD) and bone quality based on trabecular bone score (TBS) in Graves' disease patients after anti-thyroid therapy.
RESEARCH DESIGN AND METHOD
This retrospective study included premenopausal female and male patients with Graves' disease who received BMD measurement more than two times during treatment. BMD and thyroid function tests with free thyroxine (FT4), total triiodothyronine (T3), thyroid stimulating hormone (TSH), and TSH receptor antibody (TRAb) levels were collected two times during follow-up. TBS was calculated using TBS insight software (version 2.1) from dual-energy X-ray absorptiometry images.
RESULTS
Thirty Graves' disease patients (17 males, 56%; 13 premenopausal females, 44%) with a mean age of 35.3 ± 9.9 years were included. The mean follow-up period was 20.7 ± 8.5 months. The median levels of FT4, TSH and TRAb improved at follow-up [2.55 ng/dL (Interquartile range (IQR) 2.07-3.78) to 1.28 ng/dL (IQR 1.23-1.39), 0.015 mIU/L (IQR 0.01-0.04) to 0.89 mIU/L (IQR 0.35-1.55), 17.0 IU/L (IQR 5.0-40.3) to 5.0 IU/L (5.0-6.0), respectively; p < 0.001]. Median BMD (lumbar spine) values also improved from 1.118 g/cm (IQR 1.000-1.119) to 1.167 g/cm (IQR 1.050-1.219) (p = 0.001) at follow-up. TBS increased from 1.377 (IQR 1.299-1.422) to 1.390 (IQR 1.327-1.430) after treatment (p = 0.038).
CONCLUSION
Both bone quality and density improved after anti-thyroid treatment in premenopausal female and male Graves' disease patients.
目的
本研究旨在评估抗甲状腺治疗后格雷夫斯病患者基于骨密度（BMD）的骨量变化以及基于小梁骨评分（TBS）的骨质量变化。
研究设计与方法
这项回顾性研究纳入了绝经前患有格雷夫斯病的女性和男性患者，这些患者在治疗期间接受了两次以上的骨密度测量。在随访期间收集两次骨密度以及游离甲状腺素（FT4）、总三碘甲状腺原氨酸（T3）、促甲状腺激素（TSH）和促甲状腺激素受体抗体（TRAb）水平的甲状腺功能测试结果。使用TBS insight软件（2.1版）根据双能X线吸收法图像计算小梁骨评分。
结果
纳入了30例格雷夫斯病患者（17例男性，占56%；13例绝经前女性，占44%），平均年龄为35.3±9.9岁。平均随访期为20.7±8.5个月。随访时FT4、TSH和TRAb的中位数水平有所改善[分别从2.55 ng/dL（四分位数间距（IQR）2.07 - 3.78）降至1.28 ng/dL（IQR 1.23 - 1.39），从0.015 mIU/L（IQR 0.01 - 0.04）升至0.89 mIU/L（IQR 0.35 - 1.55），从17.0 IU/L（IQR 5.0 - 40.3）降至5.0 IU/L（5.0 - 6.0）；p < 0.001]。随访时腰椎的骨密度中位数也从1.118 g/cm（IQR 1.000 - 1.119）提高到1.167 g/cm（IQR 1.050 - 1.219）（p = 0.001）。治疗后小梁骨评分从1.377（IQR 1.299 - 1.422）增加到1.390（IQR 1.327 - 1.430）（p = 0.038）。
结论
绝经前患有格雷夫斯病的女性和男性患者在接受抗甲状腺治疗后，骨质量和骨密度均有所改善。
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