Song Jiamin, Li Wenxin, Yuan Guoyue, Wang Dong, Zhao Li
Endocr Connect. 2025 Jun 13;14(6). doi: 10.1530/EC-25-0110. Print 2025 Jun 1.
This research was to investigate the relationship among thyroid function, sensitivity to thyroid hormone indices, and bone mineral density (BMD) in euthyroid individuals with type 2 diabetes mellitus (T2DM).
A total of 536 euthyroid patients with T2DM were included. The subjects were measured for anthropometric parameters, biochemical indicators, and clinical characteristics. Their bone density was tested by dual-energy X-ray, and then they were classified according to their outcomes.
In comparison to the normal BMD group, the FT3 level was notably reduced in the low BMD groups (P < 0.05). The patients were sequentially assigned to tri-sectional quantiles according to FT3. Compared with tertile 1, patients in tertile 2 had a higher value of BMD. Spearman correlation analysis showed that the FT3 level was positively associated with BMD. After adjustment in multiple linear regression, FT3 level remained significantly related to decreased BMD. A significant independent association between FT3 and BMD was found by multiple logistic regression analysis after adjusting for potential confounding variables (OR = 0.187, P < 0.05). No significant relation was found between thyroid hormone indices and BMD.
FT3 level was independently associated with BMD in euthyroid patients with T2DM. High-normal FT3 may be a protective factor for BMD.
本研究旨在探讨2型糖尿病（T2DM）甲状腺功能正常个体的甲状腺功能、甲状腺激素指标敏感性与骨密度（BMD）之间的关系。
共纳入536例甲状腺功能正常的T2DM患者。测量受试者的人体测量参数、生化指标和临床特征。采用双能X线检测其骨密度，然后根据结果进行分类。
与骨密度正常组相比，低骨密度组的FT3水平显著降低（P < 0.05）。根据FT3将患者依次分为三分位数。与第一三分位数相比，第二三分位数的患者骨密度值更高。Spearman相关性分析显示，FT3水平与骨密度呈正相关。在多元线性回归调整后，FT3水平仍与骨密度降低显著相关。在调整潜在混杂变量后，通过多元logistic回归分析发现FT3与骨密度之间存在显著的独立关联（OR = 0.187，P < 0.05）。未发现甲状腺激素指标与骨密度之间存在显著关系。
在甲状腺功能正常的T2DM患者中，FT3水平与骨密度独立相关。FT3处于正常高值可能是骨密度的保护因素。
