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目的甲状腺功能影响骨代谢及骨密度,但对于骨微结构的影响却鲜有研究。骨小梁评分是近年来新出现的评估骨微结构的指标,通过测定甲状腺功能正常男性人群的骨小梁评分,探讨正常范围内甲状腺功能状态与骨微结构的相关性。方法选取186例符合入组标准的我科住院男性人群作为研究对象,检测游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)水平及一般生化指标,采用双能X线骨密度仪检测腰椎骨密度(Bone mineral density,BMD),运用TBS i Nsight软件分析腰椎DXA图像,得出骨小梁评分(Trabecular Bone Score,TBS),统计分析甲状腺功能各项指标与BMD及TBS的相关性。结果 1Pearson’s相关性分析结果显示FT3,FT4及TSH与腰椎骨密度均无显著相关性(P>0.05);FT3与TBS呈负相关(r=-0.193,P=0.009),FT4及TSH与TBS无相关性(P>0.05);2多元线性回归分析结果显示在校正年龄及体重指数后FT3与TBS的相关性仍然存在(β=-0.211,P=0.006),而FT4及TSH与TBS仍无明显相关性(P>0.05);FT3,FT4及TSH与腰椎骨密度也无相关性(P>0.05)。结论在甲状腺功能正常的男性人群中,FT3与骨小梁评分呈负相关,正常上限水平的FT3会导致骨微结构的破坏。
Purpose Thyroid function affects bone metabolism and bone mineral density, but little is known about the effects on bone microstructure. Trabecular bone scoring is a new indicator of bone microstructure evaluation in recent years. The trabecular bone score of normal male thyroid gland is measured to explore the correlation between thyroid functional status and bone microstructure in normal range. Methods A total of 186 male hospitalized adults in our department were enrolled in this study. Free FT3, free thyroxine (TSH) and thyroid-stimulating hormone (TSH) Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. DXA images of lumbar vertebrae were analyzed by TBS i Nsight software to obtain Trabecular Bone Score (TBS). Statistical analysis of thyroid function Indicators and the correlation between BMD and TBS. Results 1 Pearson’s correlation analysis showed that FT3, FT4 and TSH had no significant correlation with lumbar BMD (P> 0.05), FT3 was negatively correlated with TBS (r = -0.193, P = 0.009) (P> 0.05) .2 Multiple linear regression analysis showed that there was still a correlation between FT3 and TBS after adjusting for age and body mass index (β = -0.211, P = 0.006), while there was no significant difference between FT4, TSH and TBS (P> 0.05). There was no correlation between FT3, FT4 and TSH and lumbar BMD (P> 0.05). CONCLUSIONS: FT3 is negatively correlated with trabecular bone score in men with normal thyroid function, and normal upper limit levels of FT3 result in disruption of the bone microarchitecture.