Zantut-Wittmann Denise Engelbrecht, Quintino-Moro Alessandra, Dos Santos Priscilla Nazaré Silva, Melhado-Kimura Vaneska, Bahamondes Luís, Fernandes Arlete
Division of Endocrinology, Department of Internal Medicine, São Paulo, Brazil.
Family Planning Clinic of Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, São Paulo, Brazil.
Front Endocrinol (Lausanne). 2020 Jan 10;10:890. doi: 10.3389/fendo.2019.00890. eCollection 2019.
The objective of this study was to evaluate whether evolution of bone mineral density (BMD) is associated with the thyroid hormone profile in a cohort of euthyroid women with no other known diseases within 1 year. This was a prospective cohort study conducted at the University of Campinas, Brazil. We used a database with 52 women aged 20-39 who were followed for 1 year in a family planning outpatient clinic. The inclusion criteria were body mass index (BMI) <30 kg/m, no known diseases/medication use, fasting glucose <100 mg/dl, and 2 h glucose after a 75 g oral glucose load <140 mg/dl. The women were divided into groups of normal weight ( = 30) and overweight ( = 22). The main outcomes were BMD measured by dual-energy x-ray absorptiometry (DXA) and thyroid hormone profile (thyrotropin TSH, free triiodothyronine FT3, free thyroxine FT4, and T3/T4 ratio); other variables were body composition (DXA), calcium metabolism markers, and life habits. We used a repeated measures analysis of variance (ANOVA) and multiple regression analyses to evaluate associations. At the baseline data collection, overweight women showed a higher T3/T4 ratio, leptin, calcium, BMD in the lumbar spine and total femur, total mass, mass, and percentage of fat mass than normal weight women. At 12 months, both groups had increased FT4, calcium, ALP, femoral neck BMD, and total mass by time effect. The normal weight group presented a decrease of vitamin D when compared to the baseline. Increased BMD of the femoral neck was associated with moderate coffee intake, and as such, there were no associations found between this increase and the thyroid hormone profile. Leptin and ALP were associated with total mass variation, while leptin and PTH were associated with fat mass variation. The normal BMI was inversely associated with the variation of total mass, mass, and percentage of fat mass, and engaging in regular physical activity was inversely associated with fat mass variation. In this sample of euthyroid healthy women who were both normal weight and overweight, the thyroid hormone profile was not associated with variations in bone mineral density and body composition after a 1 year follow-up.
本研究的目的是评估在一组一年内无其他已知疾病的甲状腺功能正常的女性队列中,骨矿物质密度(BMD)的变化是否与甲状腺激素水平相关。这是一项在巴西坎皮纳斯大学进行的前瞻性队列研究。我们使用了一个数据库,其中包含52名年龄在20 - 39岁之间的女性,她们在计划生育门诊接受了为期1年的随访。纳入标准为体重指数(BMI)<30 kg/m²,无已知疾病/未使用药物,空腹血糖<100 mg/dl,以及75 g口服葡萄糖负荷后2小时血糖<140 mg/dl。这些女性被分为正常体重组(n = 30)和超重组(n = 22)。主要结局指标是通过双能X线吸收法(DXA)测量的BMD和甲状腺激素水平(促甲状腺激素TSH、游离三碘甲状腺原氨酸FT3、游离甲状腺素FT4以及T3/T4比值);其他变量包括身体成分(DXA)、钙代谢标志物和生活习惯。我们使用重复测量方差分析(ANOVA)和多元回归分析来评估相关性。在基线数据收集时,超重女性的T3/T4比值、瘦素、钙、腰椎和全股骨的BMD、总体质量、肌肉质量以及脂肪质量百分比均高于正常体重女性。在12个月时,两组的FT4、钙、碱性磷酸酶(ALP)、股骨颈BMD和总体质量均因时间效应而增加。与基线相比,正常体重组的维生素D有所下降。股骨颈BMD的增加与适量咖啡摄入有关,因此,未发现这种增加与甲状腺激素水平之间存在关联。瘦素和ALP与总体质量变化有关,而瘦素和甲状旁腺激素(PTH)与脂肪质量变化有关。正常BMI与总体质量、肌肉质量和脂肪质量百分比的变化呈负相关,而进行规律体育活动与脂肪质量变化呈负相关。在这个甲状腺功能正常的健康女性样本中,包括正常体重和超重女性,经过1年随访后,甲状腺激素水平与骨矿物质密度和身体成分的变化无关。