Campbell J, Day P, Diamond T
Department of Endocrinology, St George Hospital, Sydney, Australia.
Thyroid. 1996 Apr;6(2):75-8. doi: 10.1089/thy.1996.6.75.
We studied 10 postmenopausal women with Hashimoto's hypothyroidism treated with varying doses of L-thyroxine replacement. Each patient received incremental doses of L-thyroxine sufficient to achieve subclinical hypothyroidism, euthyroidism, and subclinical hyperthyroidism as determined by normal total serum thyroxine levels (80-160 micrograms/L) and serum TSH concentrations greater than 3.5, 0.3-3.5, and less than 0.3 mU/L, respectively. Metabolic parameters of bone turnover (including serum bone Gla-protein, serum alkaline phosphatase, serum procollagen 1, and serum carboxytelopeptide) were assessed once steady state was achieved, and measurements were compared to 10 healthy controls matched for age and years since the menopause. Our findings suggest that overzealous thyroxine replacement producing subclinical hyperthyroidism may result in an increase in bone turnover as reflected by elevated serum carboxytelopeptide concentrations.
我们研究了10名接受不同剂量左甲状腺素替代治疗的桥本氏甲状腺功能减退绝经后女性。每位患者接受递增剂量的左甲状腺素，剂量足以达到亚临床甲状腺功能减退、甲状腺功能正常和亚临床甲状腺功能亢进状态，这分别由正常的总血清甲状腺素水平（80 - 160微克/升）以及血清促甲状腺激素浓度大于3.5、0.3 - 3.5和小于0.3毫国际单位/升来确定。一旦达到稳态，就评估骨转换的代谢参数（包括血清骨钙素、血清碱性磷酸酶、血清前胶原1和血清羧基端肽），并将测量结果与10名年龄和绝经年限匹配的健康对照者进行比较。我们的研究结果表明，过度积极的甲状腺素替代导致亚临床甲状腺功能亢进，可能会导致骨转换增加，这表现为血清羧基端肽浓度升高。
