Vinther C J, Poulsen L H, Nicolaisen P, Obling M L, Brix T H, Hermann A P, Hegedüs L, Jørgensen N R, Hansen S, Bonnema S J
Department of Endocrinology, Odense University Hospital, Odense, Denmark.
Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
J Endocrinol Invest. 2023 Feb;46(2):345-358. doi: 10.1007/s40618-022-01907-2. Epub 2022 Sep 5.
This study aimed to compare changes in the bone turnover markers (BTMs)-C-terminal telopeptide of type I collagen (CTX-I) and procollagen I N-terminal peptide (PINP)-with changes in the bone microarchitecture, assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT), during treatment of patients with thyroid dysfunction.
In women with newly diagnosed hypo- or hyperthyroidism, HR-pQCT variables, obtained from the tibia and the radius, were compared with BTMs. Data were collected at diagnosis and after at least 12 months of euthyroidism.
73 women completed the study (hypothyroidism, n = 27; hyperthyroidism, n = 46). Among hyperthyroid patients, correlations were found between changes in BTMs and HR-pQCT variables, primarily for cortical variables in the tibia, i.e. cortical thickness (CTX-I, p < 0.001; PINP, p < 0.001), and volumetric bone mass density (vBMD) (CTX-I, p < 0.001; PINP, p < 0.001). Moreover, correlations between BTMs and estimated bone strength were found. In the hypothyroid subgroup, no significant findings existed after adjustment. Following treatment, less decrease in tibial vBMD was seen among patients with increasing CTX-I compared to those with a decreasing CTX-I level (p = 0.009). Opposite findings applied to PINP, as patients with decreasing PINP showed an increase in tibial vBMD, in contrast to a decline in this parameter among patients with increasing PINP (p < 0.001).
Changes in CTX-I and PINP correlated with HR-pQCT variables during the treatment of women with thyroid dysfunction. To some extent, these BTMs reflected the restoration of bone microarchitecture. CTX-I seems to be the most sensitive BTM in treatment-naïve thyroid diseases, while PINP is more useful for monitoring during treatment.
NCT02005250. Date: December 9, 2013.
本研究旨在比较骨转换标志物（BTMs）——I型胶原C末端肽（CTX-I）和I型前胶原N末端肽（PINP）的变化与通过高分辨率外周定量计算机断层扫描（HR-pQCT）评估的骨微结构变化，这些变化发生在甲状腺功能障碍患者的治疗过程中。
在新诊断为甲状腺功能减退或亢进的女性中，将从胫骨和桡骨获得的HR-pQCT变量与BTMs进行比较。在诊断时以及甲状腺功能正常至少12个月后收集数据。
73名女性完成了研究（甲状腺功能减退，n = 27；甲状腺功能亢进，n = 46）。在甲状腺功能亢进患者中，发现BTMs变化与HR-pQCT变量之间存在相关性，主要是胫骨的皮质变量，即皮质厚度（CTX-I，p < 0.001；PINP，p < 0.001）和骨体积密度（vBMD）（CTX-I，p < 0.001；PINP，p < 0.001）。此外，还发现了BTMs与估计骨强度之间的相关性。在甲状腺功能减退亚组中，调整后未发现显著结果。治疗后，与CTX-I水平下降的患者相比，CTX-I升高的患者胫骨vBMD下降较少（p = 0.009）。PINP则相反，PINP下降的患者胫骨vBMD增加，而PINP升高的患者该参数下降（p < 0.001）。
在甲状腺功能障碍女性的治疗过程中，CTX-I和PINP的变化与HR-pQCT变量相关。在一定程度上，这些BTMs反映了骨微结构的恢复。CTX-I似乎是初治甲状腺疾病中最敏感的BTM，而PINP在治疗期间监测更有用。
NCT02005250。日期：2013年12月9日。
