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目的 研究甲状腺功能亢进症 (甲亢 )患者新的骨代谢指标的变化。方法 测定 44例甲亢患者及 3 8例健康对照者的血清钙、磷、总碱性磷酸酶 (ALP)、骨钙素 (OC)、尿脱氧吡啶啉 (DPD)的水平。结果 甲亢组除血钙 (2 .40 3± 0 .189vs 2 .40 0± 0 .12 9,P =0 .0 7)与对照组无明显差别外 ,血磷 (1.2 5± 0 .0 9vs 1.12± 0 .0 6,P <0 .0 1)、ALP(10 0 .2 5± 12 .64vs 5 3 .5 5± 8.5 8,P <0 .0 1)、OC(13 .0 7± 3 .0 9vs 6.2 4± 1.5 7,P <0 .0 1)和尿DPD(3 1.62 3± 4.87vs 4.63 4± 0 .945 ,P <0 .0 1)均较对照组有明显增高。骨形成指标OC、ALP分别增高 110 %、87% ,而骨吸收指标尿DPD增高 62 8% ,以尿DPD活性增高更为显著 ,尿DPD与患者年龄、病程不相关。血ALP与T4呈正相关 ,尿DPD、血OC与T3 呈正相关。结论 甲亢患者由于高水平甲状腺激素的作用骨代谢增强 ,骨吸收大于骨形成 ;尿DPD是反映骨吸收的一项敏感而特异的指标
Objective To study the changes of new bone metabolism index in patients with hyperthyroidism (hyperthyroidism). Methods Serum levels of calcium, phosphorus, total alkaline phosphatase (ALP), osteocalcin (OC), and urine deoxypyridinoline (DPD) were measured in 44 hyperthyroid patients and 38 healthy controls. Results In the hyperthyroidism group, serum calcium (1.2 5 ± 0. 09vs vs 1.12 ± 0.06, P <0.01), ALP (100.25 ± 12.64 vs 53.5 ± 8.58, P <0.01), OC (13.0 ± 0.7 3 .0 9 vs 6.2 4 ± 1.5 7, P <0.01) and urinary DPD (3 1.62 3 ± 4.87 vs 4.63 4 ± 0. 945, P <0.01) were significantly higher than the control group. Bone formation index OC, ALP increased 110%, 87%, respectively, while the bone resorption index of urine DPD increased 62 8% to urinary DPD activity was more significant, urinary DPD and patient age and duration of disease is not related. Blood ALP and T4 were positively correlated, urinary DPD, blood OC and T3 were positively correlated. Conclusions Hyperthyroidism patients have increased bone metabolism due to the high level of thyroid hormone, and bone resorption is greater than bone formation. Urinary DPD is a sensitive and specific indicator of bone resorption