摘要
目的探讨甲状腺激素替代治疗前后甲减患者血清骨保护素（0PG），血清骨钙素（OCN）的变化。方法选择健康者15例和甲减患者30例，其中临床甲减（oHT）和亚临床甲减（sliT）各15例。所有甲减患者采用左旋甲状腺素（L-T4）补充治疗至甲状腺功能在正常范围内。血清0PG、OCN采用酶联免疫法测定。结果L．T4治疗前oHT和sliT患者血清OPG水平分别为3．604-0．38ng／ml和3．51±0．32ng／ml，明显高于对照组（2．684-0．48rig／ml，P=0．000）；血清OC]N水平分别为3．36±0．87ng／ml和3．42±0．75ng／ml，明显低于对照组（4．79±0．87ng／ml，P=0．000）；多元回归分析结果显示，oHT和sliT患者血清OPG均与TSH呈正相关（r=0．580，P=0．023；r=0．934，P=0．000），血清OCN均与TSH呈负相关（r=-0．964，P=0．000；r=-0．825，P：0．000）。治疗至甲状腺功能正常后，两组血清OPG水平明显降低（分别为2．77±0．37ng／ml和2．92±0．31ng／ml，P=0．000），接近对照组水平；血清OCN水平明显升高（分别为4．63±0．70ng／ml和4．62±0．70ng／ml，P=0．000），接近对照组水平。结论甲减患者L-T4治疗后骨代谢紊乱可能得到改善。
Objective To explore the changes of serum osteoprotegerin （OPG） and osteocalcin （OCN） before and after levothyroxine （ L-T4 ） replacement therapy for the treatment of hypothyroidism patients. Methods Fifteen healthy people and thirty hypothyroidism patients were selected, including 15 overt hypothyroidism （oHT） and 15 subclinical hypothyroidism （sliT） patients, respectively. All hypothyroidism patients were treated with L-T4 until the thyroid function recovered to the normal range. The serum OPG and OCN concentrations were measured using ELISA. Results The serum OPG levels of oHT and sliT patients were 3.60 ± 0.38 ng/ml and 3.51 ＋ 0.32 ng/ml, respectively, before the treatment. These were significantly higher than that of the controls （2.68± 0. 48ng/ml, P = 0. 000）. The serum OCN levels of oHT and sliT patients were 3.36 ±0.87ng/ml and 3.42 ±0.75ng/ml, respectively, before the treatment. These were significantly lower than that of the controls （4.79 ± 0. 87ng/L, P = 0. 000）. Multivariate regression analysis showed that OPG of oHT and slit patients was positively associated with TSH （ r = 0. 580, P =0. 023; r = 0. 934, P = 0. 000）, and OCN of oHT and sliT patients was negatively associated with TSH （r = -0.964, P =0.000; r = -0.825,P =0.000）. After the thyroid function recovered to normal range, serum OPG levels of the two groups significantly decreased and ch）sed to normal range （2. 77±0. 37 ng/ml and 2. 92± 0. 31ng/ml, respectively, P = 0. 000）. Serum OCN levels of the two groups significantly increased and closed to normal range （4.63 ±0.70 ng/ml and 4.62± 0. 70 ng/ml, respectively, P = 0. 000）. Conclusion Bone metabolic dysfunction can be ameliorated after the L-T4 replacement therapy in hypothyroidism patients.
出处
《中国骨质疏松杂志》
CAS
CSCD
2011年第12期1077-1079,1083,共4页
Chinese Journal of Osteoporosis
