CAJ | 학술논문

目的：通过测定甲状腺功能正常的绝经后2型糖尿病妇女的骨密度，探讨正常范围内促甲状腺激素（ TSH）的水平与骨密度的关系。方法选取在我院内分泌科住院治疗的甲功正常的绝经后T2DM女性患者220例，根据血清TSH水平，以1?60 mU／L和2?90 mU／L为界，将入选患者分为3组，即A组（0?27 mU／L～1?60 mU／L）、B组（1?60 mU／L～2?90 mU／L）、C组（2?90 mU／L～4?20 mU／L）。比较各组的一般情况、生化指标、骨密度（BMD）的差异。结果①与B组相比，A组患者左股骨颈、转子和全髋部BMD降低，差异有统计学意义（P＜0?05），而AC、BC两两比较差异无统计学意义（P＞0?05，P＞0?05）；②对于甲功正常的绝经后T2DM女性患者，血清FT3与全髋部BMD呈正相关（r＝0?292，P＝0?039），TSH、FT4与全髋部BMD无相关（r＝0?078，P＝0?594；r＝－0?043，P＝0?771）；③校正年龄、绝经年限、BMI后，FT3与全髋部BMD仍呈正相关（r＝0?401，P＝0?006），TSH、FT4与全髋部BMD仍无相关（r＝0?013，P＝0?929；r＝0?039，P＝0?797）；④在多元线性回归中，FT3仍与全髋部BMD独立相关（B＝0?114，P＝0?006）。结论在甲功正常的绝经后T2DM妇女中，低TSH会降低全髋BMD；血清FT3与全髋BMD呈正相关，而TSH、FT4与全髋部BMD无相关。
목적：통과측정갑상선공능정상적절경후2형당뇨병부녀적골밀도，탐토정상범위내촉갑상선격소（ TSH）적수평여골밀도적관계。방법선취재아원내분비과주원치료적갑공정상적절경후T2DM녀성환자220례，근거혈청TSH수평，이1?60 mU／L화2?90 mU／L위계，장입선환자분위3조，즉A조（0?27 mU／L～1?60 mU／L）、B조（1?60 mU／L～2?90 mU／L）、C조（2?90 mU／L～4?20 mU／L）。비교각조적일반정황、생화지표、골밀도（BMD）적차이。결과①여B조상비，A조환자좌고골경、전자화전관부BMD강저，차이유통계학의의（P＜0?05），이AC、BC량량비교차이무통계학의의（P＞0?05，P＞0?05）；②대우갑공정상적절경후T2DM녀성환자，혈청FT3여전관부BMD정정상관（r＝0?292，P＝0?039），TSH、FT4여전관부BMD무상관（r＝0?078，P＝0?594；r＝－0?043，P＝0?771）；③교정년령、절경년한、BMI후，FT3여전관부BMD잉정정상관（r＝0?401，P＝0?006），TSH、FT4여전관부BMD잉무상관（r＝0?013，P＝0?929；r＝0?039，P＝0?797）；④재다원선성회귀중，FT3잉여전관부BMD독립상관（B＝0?114，P＝0?006）。결론재갑공정상적절경후T2DM부녀중，저TSH회강저전관BMD；혈청FT3여전관BMD정정상관，이TSH、FT4여전관부BMD무상관。
Objective To investigate the relationship between normal range of thyroid stimulating hormone ( TSH) and hip bone mineral density ( BMD ) in postmenopausal women with type 2 diabetes by BMD test. Methods Two hundred and twenty postmenopausal females with type 2 diabetes were chosen from hospitalized patients in our endocrinology. They were divided into 3 groups according to their levels of serum TSH, group A (0?27-1?60 mU/L), group B (1?60-2?90 mU/L), and group C (2?90-4?20 mU/L) . Their general condition, biochemical parameters, and BMD were compared. Results ( 1 ) BMD of the left femoral neck, trochanter, and total hip decreased significantly in group A comparing to that in group B (P<0?05), while there was no statistical difference between group A and C, and between group B and C ( P>0?05 ) . ( 2 ) For postmenopausal females with type 2 diabetes who had normal thyroid function, serum FT3 was positively correlated with total hip BMD (r=0?292, P=0?039), while there was no correlation between TSH, FT4 and total hip BMD (r=0?078, P=0?594;r= -0?043, P=0?771). (3) After adjustment for age, postmenopausal time, and BMI, serum FT3 was still positively correlated with total hip BMD (r=0?401, P=0?006), while there was still no correlation between TSH, FT4 and total hip BMD (r=0?013, P=0?929;r=0?039, P=0?797). (4) In the multiple liner regression, FT3 was still associated with total hip BMD independently (B = 0?114, P = 0?006). Conclusion Low TSH level decreases total hip BMD in postmenopausal females with type 2 diabetes and normal thyroid function. Serum FT3 is positively correlated with total hip BMD. FT4 and TSH are not correlated with total hip BMD.