【摘要】 目的探讨甲状腺功能正常的T2DM患者甲状腺激素水平与骨密度（BMD）的关系。方法选取北京大学人民医院甲状腺功能正常的T2DM患者650例（男396例,女254例）,采用双能X射线骨密度仪测定腰椎、股骨颈及全髋BMD,并分为骨量正常组（n=261）、骨量减少组（n=307）及骨质疏松组（OP,n=82）。比较3组各项指标的差异,并与BMD进行相关性分析。结果 OP组体重、WC、SUA及血清游离甲状腺素（FT₄）水平低于其他两组（P<0. 05）,血清骨特异性碱性磷酸酶（BALP）及抗酒石酸酸性磷酸酶（TRACP-5b）高于其他两组（P<0. 05）。校正年龄及体重等影响因素后,股骨颈BMD与甲状旁腺激素（PTH）、BALP呈负相关（r=-0. 13,-0. 228,P=0. 003,0. 001）,腰椎BMD与血清游离三碘甲状腺原氨酸（FT₃）、PTH、BALP、TRAP-5b呈负相关（r=-0. 113、-0. 113、-0. 245、-0. 14,P=0. 011、0. 011、0. 001、0. 002）。多元线性回归分析结果显示,年龄、BMI、BALP是股骨颈BMD的影响因素（P<0. 01）;年龄、BMI、BALP、FT₃、FT₄是腰椎BMD的影响因素（P<0. 05）。结论在甲功正常的T2DM患者中,FT₄及FT₃与腰椎BMD相关。更多还原

【Abstract】 Objective To investigate the relationship between thyroid hormone and bone mineral density（BMD） in patients with type 2 diabetes（T2DM） and normal thyroid function. Methods A total of 650 T2DM patients（Male 396, female 254） with normal thyroid function were selected in this study.BMD of lumbar vertebra,femoral neck and total hip were determined by using dual-energy X-ray absorptiometry（DEXA）. All the patients were divided into 3 groups according to their T scores : normal BMD group :T≥-1. 0 SD; osteopenia group :-2. 5<T<-1. 0 SD; osteoporosis group: T≤-2.5 SD group. Vatious indicators compared to their correlations with BMD were analyzed among the three groups. Results The weight,waist,serum uric acid（SUA） and circulating free thyroxine（FT₄） were significantly lower in osteoporosis group than in normal BMD group and osteopenia group（P<0.05）. Serum bone specific alkaline phosphatase（BALP） and tartra-resistant acid phosphatase（TRACP-5b） were significantly higher in osteoporosis group than in the other two groups（P<0.05）. After adjustment for age and weight, The BMD of femoral neck was negatively correlated with PTH and BALP（r=-0.13,-0.228,P= 0. 003,0. 001） and the BMD of lumbar vertebrae was negatively correlated with FT₃、PTH、BALP and TRACP-5 b（r=-0.113,-0.113,-0.245,-0.14,P=0.011,0.011,0.001,0.002）. Multiple linear regression showed that age,BMI and BALP were independently correlated with the BMD of femoral neck（P<0. 001）,while age,BMI,BALP,FT₃ and FT₄ were independently correlated with the BMD of lumbar vertebrae（P<0. 05）.Conclusion In T2DM patients with normal thyroid function,FT₃ and FT₄ were related to the BMD of lumbar vertebrae.更多还原