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甲状腺功能亢进症患者的骨密度及其与血清25-羟基维生素D水平的相关性。

Bone mineral density and its correlation with serum 25-hydroxyvitamin D levels in patients with hyperthyroidism.

作者信息

Liu Haixia, Ma Qihang, Han Xinli, Huang Wenwen

机构信息

Weifang People's Hospital, Weifang City, Shandong Province, China.

Weifang Traditional Chinese Hospital, Weifang City, Shandong Province, China.

出版信息

J Int Med Res. 2020 Feb;48(2):300060520903666. doi: 10.1177/0300060520903666.

Abstract

OBJECTIVE

This study aimed to determine the association between 25-hydroxyvitamin D (25(OH)D) levels and bone mineral density (BMD) in patients with hyperthyroidism after undergoing treatment.

METHODS

A total of 120 patients with hyperthyroidism were selected as participants. Methimazole tablets were provided to all of the participants, with an initial dose of 20 mg/day and a maintenance dose of 2.5 mg/day for 1 year. Blood calcium, phosphate, parathyroid hormone (PTH), and thyroid hormone levels were assayed using an automatic biochemical analyzer. Levels of 25(OH)D and bone alkaline phosphatase (ALP) in serum were determined by enzyme-linked immunosorbent assay. BMD was measured using dual energy X-ray absorptiometry.

RESULTS

Serum phosphorus, PTH, and 25(OH)D levels in patients with hyperthyroidism were significantly higher, and bone ALP and 24-hour urinary calcium levels were significantly lower after treatment compared with before treatment. BMD in patients with hyperthyroidism was significantly improved after treatment. In logistic regression analysis of BMD-related risk factors, bone ALP, PTH, and 25(OH)D levels were risk factors of BMD.

CONCLUSION

Treatment for hyperthyroidism should be supplemented with vitamin D and calcium, which have important clinical significance for adjusting bone metabolism and delaying the process of osteoporosis.

摘要

目的

本研究旨在确定接受治疗的甲状腺功能亢进症患者的25-羟维生素D(25(OH)D)水平与骨密度(BMD)之间的关联。

方法

共选取120例甲状腺功能亢进症患者作为研究对象。所有参与者均服用甲巯咪唑片,初始剂量为20毫克/天,维持剂量为2.5毫克/天,持续1年。使用自动生化分析仪检测血钙、血磷、甲状旁腺激素(PTH)和甲状腺激素水平。采用酶联免疫吸附测定法测定血清中25(OH)D和骨碱性磷酸酶(ALP)水平。使用双能X线吸收法测量骨密度。

结果

与治疗前相比,甲状腺功能亢进症患者治疗后的血清磷、PTH和25(OH)D水平显著升高,骨ALP和24小时尿钙水平显著降低。甲状腺功能亢进症患者治疗后的骨密度显著改善。在对骨密度相关危险因素的逻辑回归分析中,骨ALP、PTH和25(OH)D水平是骨密度的危险因素。

结论

甲状腺功能亢进症的治疗应补充维生素D和钙,这对调节骨代谢和延缓骨质疏松进程具有重要的临床意义。

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