Korsić M, Cvijetić S, Dekanić-Ozegović D, Bolanća S, Kozić B
Zavod za endokrinologiju, dijabetes i bolesti metabolizma, KBC Rebro, Zagreb.
Lijec Vjesn. 1998 May;120(5):103-5.
The aim of the study was to determine the influence of replacement and suppressive thyroxine therapy on bone mineral density (BMD). 30 postmenopausal women; 19 on replacement therapy (dose 1.22 +/- 0.35 micrograms/kg; duration 11.4 +/- 7.2 years) and 11 on suppressive therapy (dose 1.45 +/- 0.71 micrograms/kg; duration 9.5 +/- 7.2 years). Controls were 60 healthy women matched for age and menopausal status. BMD at the lumbar spine (L2-L4), femoral neck, Ward's triangle and trochanter was measured by dual-energy absorptiometry. Forearm BMD at distal site was measured by single-photon absorptiometry. Mean thyroid hormone values and TSH were within normal limits, although the patients on suppressive therapy had significantly higher T3 (p < 0.05) than the patients on replacement therapy. BMD on each site was significantly lower in the replacement treated group than in controls. BMD in patients on suppressive therapy was lower, but not significantly, compared to controls. Thyroxine therapy could have an adverse effect on BMD. The magnitude of bone loss depends on the serum level of thyroid hormones and on the functional state of thyroid hormone receptor in bone tissue, as well.
本研究的目的是确定甲状腺素替代治疗和抑制治疗对骨密度（BMD）的影响。30名绝经后女性，19名接受替代治疗（剂量1.22±0.35微克/千克；疗程11.4±7.2年），11名接受抑制治疗（剂量1.45±0.71微克/千克；疗程9.5±7.2年）。对照组为60名年龄和绝经状态相匹配的健康女性。采用双能吸收法测量腰椎（L2-L4）、股骨颈、Ward三角区和大转子处的骨密度。采用单光子吸收法测量远端部位的前臂骨密度。平均甲状腺激素值和促甲状腺激素（TSH）在正常范围内，尽管接受抑制治疗的患者的T3显著高于接受替代治疗的患者（p<0.05）。接受替代治疗组各部位的骨密度均显著低于对照组。与对照组相比，接受抑制治疗患者的骨密度较低，但差异不显著。甲状腺素治疗可能对骨密度有不良影响。骨质流失的程度还取决于甲状腺激素的血清水平以及骨组织中甲状腺激素受体的功能状态。
