Chen Yi, Zhang Wen, Chen Chi, Wang Yuying, Wang Ningjian, Lu Yingli
Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
Endocr Connect. 2022 Mar 31;11(3):e210484. doi: 10.1530/EC-21-0484.
We aimed to evaluate whether thyroid hormones, autoimmune and thyroid homeostasis status were related to bone turnover in type 2 diabetes.
The data were obtained from a cross-sectional study, the METAL study. In this study, 4209 participants (2059 men and 2150 postmenopausal women) with type 2 diabetes were enrolled. Thyroid function, thyroid antibodies and three bone turnover markers (BTMs), including a large N-mid fragment of osteocalcin (N-MID osteocalcin), β-C-terminal cross-linked telopeptides of type I collagen (β-CTX) and procollagen type I N-terminal propeptide (P1NP), were measured. Thyroid homeostasis parameters, including the sum activity of step-up deiodinases (SPINA-GD), thyroid secretory capacity (SPINA-GT), Jostel's TSH index (TSHI) and the thyrotroph thyroid hormone resistance index (TTSI), were calculated. The associations of thyroid parameters with BTMs were analyzed using linear regression.
Free and total triiodothyronine were positively associated with N-MID osteocalcin and P1NP in both sexes and positively associated with β-CTX in postmenopausal women. Thyroid-stimulating hormone was negatively associated with β-CTX in postmenopausal women, and free thyroxine was negatively associated with N-MID osteocalcin and P1NP in men. SPINA-GD was positively associated with N-MID osteocalcin and P1NP in both sexes. There was a positive relationship of SPINA-GT with β-CTX, a negative relationship of TTSI with β-CTX, and a negative relationship of TSHI with β-CTX and P1NP in postmenopausal women.
Among men and postmenopausal women with type 2 diabetes, significant associations were observed between N-MID osteocalcin, β-CTX and P1NP with thyroid function and thyroid homeostasis. Further prospective studies are warranted to understand the causal relationship and underlying mechanism.
我们旨在评估甲状腺激素、自身免疫及甲状腺内环境稳定状态是否与2型糖尿病患者的骨转换有关。
数据来自一项横断面研究，即METAL研究。该研究纳入了4209例2型糖尿病患者（2059例男性和2150例绝经后女性）。检测甲状腺功能、甲状腺抗体及三种骨转换标志物（BTMs），包括骨钙素的大N端中段片段（N-MID骨钙素）、I型胶原β羧基端交联肽（β-CTX）和I型前胶原N端前肽（P1NP）。计算甲状腺内环境稳定参数，包括促甲状腺素酶总和活性（SPINA-GD）、甲状腺分泌能力（SPINA-GT）、约斯特尔促甲状腺激素指数（TSHI）和促甲状腺激素甲状腺激素抵抗指数（TTSI）。采用线性回归分析甲状腺参数与BTMs的相关性。
游离三碘甲状腺原氨酸和总三碘甲状腺原氨酸在男女两性中均与N-MID骨钙素和P1NP呈正相关，在绝经后女性中与β-CTX呈正相关。促甲状腺激素在绝经后女性中与β-CTX呈负相关，游离甲状腺素在男性中与N-MID骨钙素和P1NP呈负相关。SPINA-GD在男女两性中均与N-MID骨钙素和P1NP呈正相关。在绝经后女性中，SPINA-GT与β-CTX呈正相关，TTSI与β-CTX呈负相关，TSHI与β-CTX和P1NP呈负相关。
在患有2型糖尿病的男性和绝经后女性中，观察到N-MID骨钙素、β-CTX和P1NP与甲状腺功能及甲状腺内环境稳定之间存在显著关联。有必要进行进一步的前瞻性研究以了解因果关系及潜在机制。
