Correlation between bone mineral density and serum bone metabolism indexes in patients with hyperthyroidism / 中国基层医药

ABSTRACT

Objective:To correlate bone mineral density with serum bone metabolism indexes in patients with hyperthyroidism.Methods:Thirty patients with hyperthyroidism who received treatment in the General Hospital of Taiyuan Iron and Steel (Group) Co., Ltd. from January 2018 to August 2019 were included in the hyperthyroidism group. Additional 30 healthy subjects who concurrently received routine physical examination were included in the control group. Bone mineral density in all subjects was measured by dual energy X-ray absorptiometry. Bone metabolism indexes in all subjects were measured using a Roche chemiluminescence instrument 25-hydroxyvitamin D level [25(OH)D], aminoterminal propeptide of type I procollagen (PINP) and beta-cardiotoxin (β-CTX). Correlation between bone mineral density and serum bone metabolism indexes was analyzed using Spearman method.Results:Bone mineral density in lumbar vertebrae 1-4 [(0.86 ± 0.14) g/cm 3], left femoral neck [(0.79 ± 0.07) g/cm 3] and left hip joint [(0.72 ± 0.10) g/cm 3] in the hyperthyroidism group was significantly lower than that in the control group [(1.28 ± 0.21) g/cm 3, (1.03 ± 0.18) g/cm 3, (0.86 ± 0.13) g/cm 3, t = 9.115, 6.806, 4.675, all P < 0.001]. There were 6 cases of osteoporosis, 12 cases of osteopenia and 12 cases of normal bone in the hyperthyroidism group. There was 1 case of osteoporosis, 6 cases of osteopenia and 23 cases of normal bone in the control group. There was significant difference in the number of cases developing osteoporosis between hyperthyroidism and control groups ( Z = 2.968, P < 0.05). Serum level of 25(OH)D in the hyperthyroidism group was significantly lower than that in the control group [(16.89 ± 4.31) μg/L vs. (24.13 ± 5.48) μg/L, t = 5.688, P < 0.001]. Serum levels of PINP and β-CTX in the hyperthyroidism group were significantly lower than those in the control group [PINP (49.37 ± 10.23) μg/L vs. (47.68 ± 6.49) μg/L; β-CTX (774.56 ± 159.67) ng/L vs. (534.32 ± 167.48) ng/L, t = 45.974 and 5.687, both P < 0.001]. In the hyperthyroidism group, bone mineral density at lumbar vertebrae 1-4, left femoral neck and left hip joint was positively correlated with serum level of 25(OH)D ( r = 0.417, 0.396, 0.401, all P < 0.05), and it was negatively correlated with serum levels of PINP and β-CTX ( r = -0.414, -0.399, -0.432, -0.404, -0.387, -0.412, all P < 0.05). Conclusion:Hyperthyroidism patients generally have low bone mineral density and accelerated bone metabolism. It is of great significance to regularly monitor bone mineral density and serum bone metabolism indexes in hyperthyroidism patients to prevent osteoporosis.