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| 老年2型糖尿病患者正常甲状腺功能与骨密度的相关性研究 |
| The relationship between normal thyroid function and bone mineral density in elderly patients with type 2 diabetes |
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| DOI：10.3969/j.issn.1006-7108.2018.08.010 |
| 中文关键词: 甲状腺功能 骨密度 2型糖尿病 老年 |
| 英文关键词:Thyroid function Bone mineral density Type 2 diabetes Elderly |
| 基金项目:国家自然科学基金项目（81500630） |
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| 中文摘要: |
| 目的 探讨老年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）的关系。方法 回顾分析我院内分泌科住院治疗的甲状腺功能正常的老年T2DM患者共515例（男性208例，女性307例），均行双能X线骨密度仪检查脊柱L1~4及左侧股骨BMD，并分析脊柱L1~4及左侧股骨BMD与促甲状腺激素(TSH)、游离甲状腺素(FT4)、游离三碘甲腺原氨酸(FT3)及其他临床指标的关系。结果 多元线性逐步回归分析显示甲状腺功能正常的老年T2DM患者脊柱L1~4及左侧股骨BMD与 TSH、FT4、FT3均无相关（P>0.05）；进一步将整体人群分为男女亚组后行多元线性逐步回归分析发现，正常范围内的TSH是老年女性T2DM患者脊柱L1~4 BMD的独立保护因素（β=0.036，P<0.01），而与其左侧股骨BMD无相关，且与老年男性T2DM患者脊柱L1~4及左侧股骨BMD均无相关。结论 正常范围内TSH对老年T2DM患者BMD的影响存在性别及BMD检测部位的差异；正常范围内的TSH是老年女性T2DM患者脊柱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) in elderly patients with type 2 diabetes (T2DM). Methods A total cases of 515 elderly T2DM patients (208 males and 307 females) with euthyroidism were reviewed. BMD of lumbar spine L1-4 and left femur was measured using dual-energy X-ray absorptiometry, then the relationship between BMD and TSH, FT4, FT3 and other clinical indicators was analyzed. Results Multivariate linear stepwise regression analysis showed that BMD of lumbar spine L1-4 and left femur was not correlated with TSH, FT4 and FT3 in elderly euthyroid patients with T2DM (P>0.05). Further multiple linear stepwise regression analysis by gender showed that TSH in the normal range was an independent protective factor for BMD of lumbar spine L1-4 in elderly women with T2DM (β=0.036, P<0.01), but not correlated with left femur BMD, and not correlated with BMD of lumbar spine L1-4 and left femur in elderly man with T2DM. Conclusion The effects of TSH within normal range on BMD in elderly T2DM patients were found to be varied by gender and BMD measurement sites. In elderly euthyroid women with T2DM, TSH was an independent protective factor for BMD of the lumbar spine. |
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