老年男性2型糖尿病患者正常范围内甲状腺功能与骨密度的相关性研究

Correlation between normal thyroid function and bone mineral density in elderly male patients with type 2 diabetes mellitus

中文关键词: 老年  骨质疏松  甲状腺功能  2型糖尿病  促甲状腺激素

英文关键词: elderly  osteoporosis  thyroid function  type 2 diabetes mellitus  thyroid-stimulating hormone

中文摘要:

      目的 探讨老年男性2 型糖尿病(type 2 diabetes mellitus,T2DM)患者正常范围内的甲状腺功能与骨密度(bone mineral density,BMD)及BMD绝对值T值的关系.方法 回顾性分析2020 年8 月—2022 年3 月于淮安市第一人民医院住院甲状腺功能正常的老年男性T2DM患者226 例(设为T2DM组)的临床资料,同期年龄匹配的体检健康男性49 例设为对照组.记录并比较2 组DXA测得的脊柱L1-4、左侧股骨颈、全髋BMD以及BMD绝对值T值,分析各部位BMD、绝对值T值与促甲状腺激素(TSH)及其他临床指标的关系.结果 T2DM组全髋BMD与BMI、血清TSH水平正相关(P＜0.05),全髋BMD绝对值T值与年龄、HDL负相关,与TSH、BMI正相关(P＜0.05),股骨颈BMD绝对值T值与BMI、TSH水平成正性相关(P＜0.05).对照组各部位骨密度仅与BMI呈正性相关(P＜0.05).正常范围内的TSH是老年男性T2DM患者全髋BMD的独立保护因素(B =0.146,P =0.034),FT4、FT3、CHOL、HDL等因素与骨密度无独立相关性.结论 老年男性T2DM患者TSH水平(正常范围内)与髋部整体BMD及股骨颈、髋部BMD绝对值T值呈正相关性;在此类患者群体中,TSH指标在正常范围内可能成为髋部BMD的独立保护因素.

英文摘要:

      Objective To investigate the relationship between normal thyroid function and bone mineral density (BMD), as well as BMD absolute T?value, in male patients with type 2 diabetes mellitus (T2DM). Methods The clinical data of 226 elderly male T2DM patients with normal thyroid function admitted to First People??s Hospital of Huai??an City from August 2020 to March 2022 (T2DM group) were retrospectively analyzed. Additionally, 49 age?matched healthy male sub? jects who underwent physical examination at the same period were set as the control group. The BMD and absolute BMD T? values of lumbar spine L1 -4 , left femoral neck, and total hip measured by dual?energy X?ray absorptiometry (DXA) were re? corded and compared between the two groups. The relationship between BMD and absolute T value and thyroid stimulating hormone (TSH) and other clinical indexes were analyzed. Results In T2DM group, BMD of total hip was positively corre? lated with body mass index (BMI) and serum TSH level (P <0. 05); BMD absolute T?value of total hip was negatively cor? related with age and high?density lipoprotein (HDL), and positively correlated with TSH and BMI (P <0. 05); BMD abso? lute T?value of femoral neck was positively correlated with BMI and TSH level (P <0. 05). In the control group, BMD of each part was only positively correlated with BMI (P <0. 05). TSH within the normal range was an independent protective factor for total hip BMD in elderly male T2DM patients (B =0. 146, P =0. 034), while FT4, FT3, cholesterol (CHOL), HDL and other factors were not independently correlated with BMD. Conclusion There is a positive correlation between TSH level (within the normal range) and overall hip BMD, as well as absolute T?values of femoral neck and hip BMD in elderly male T2DM patients. In this patient population, TSH within the normal range may be an independent protective factor for hip BMD.