| Objective To analyze the effect of serum thyroid stimulating hormone(TSH)level on bone mineral density in normal range.Methods A total of 2885 people in Gansu area,aged 18-87 years,were enrolled in the national survey of thyroid diseases and iodine nutrition status(Tide).A total of 1955 normal thyroid functions were screened out,including 1059 males,630 non-menopausal women and 266 menopausal women.According to the serum TSH level,the selected men,non-menopausal women and menopausal women were divided into three groups,Male: T1 group(0.39-1.80)m IU/L,T2 group(1.81-2.70)m IU/L and T3 group(2.71-4.20)m IU/L,non-menopausal women: Q1 group(0.30-2.00)m IU/L,Q2 group(2.01-2.80)m IU/L and Q3 group(2.81-2.81)m IU/L;Postmenopausal women: N1 group(0.28-2.01)m IU/L,N2 group(2.02-3.23)m IU/L and N3 group(3.24-4.20)m IU/L.To compare the difference of blood calcium,phosphorus,25(OH)D,right calcaneal BMD and left forearm BMD between different TSH levels.To investigate the difference in the prevalence of left forearm and right calcaneus osteoporosis among different TSH levels.To analyze the correlation between TSH levels and BMD;To assess the risk of osteoporosis at different levels of TSH;To analyze the correlation between thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TGAb)levels and BMD.Results(1)The prevalence rate of left forearm osteoporosis: the total prevalence rate of 17.3%,male 21.8%,non-menopause women 3.6%,postmenopausal women 32.5%,The incidence of osteoporosis in postmenopausal women was significantly higher than that in men(P<0.05),and the incidence of osteoporosis in postmenopausal women was significantly higher than that of non-menopausal women(P<0.05),and the prevalence rate of male osteoporosis was significantly higher than that of non-menopausal women(P<0.05).The prevalence rate of the right calcaneus osteoporosis: the total prevalence rate of 20.7%,male 21.8%,non menopause female 9.2%,postmenopausal women 37.2%,The incidence of osteoporosis in postmenopausal women was significantly higher than that in men(P<0.05),and the incidence of osteoporosis in postmenopausal women was significantly higher than that in unmenopausal women(P<0.05),and the prevalence rate of male osteoporosis was significantly higher than that in unmenopausal women(P<0.05).(2)Male: The right calcaneus BMD,blood calcium and phosphorus in the T3 group was significantly higher than that in the T1 group(P<0.05),There were no significant differences in age,BMI,waist circumference,25(OH)D and BMD of left forearm between the three groups(P>0.05).Postmenopausal women: The BMD of the right calcaneus and the left forearm in the N3 group were significantly higher than those in the N1group(P<0.05),The BMD of the right calcaneus and the left forearm in the N3 group were significantly higher than those in the N2group(P<0.05).Non menopausal women: There was no significant difference in age,BMI,waist circumference,blood calcium,blood phosphorus,25(OH)D,BMD of left forearm and right calcaneal between the three groups(P>0.05).(3)Among postmenopausal women:The incidence of osteoporosis in the right calcaneus and left forearm in the N1 group was significantly higher than that in the N3 group(P<0.05).The incidence of osteoporosis in the right calcaneus in the N2 group was significantly higher than that in the N3 group(P<0.05);Among man,the prevalence of osteoporosis in the right calcaneus was not significantly different between the three TSH groups,and the incidence of osteoporosis in the left forearm was not significantly different in the three TSH groups.Among unmenopausal women,the prevalence of osteoporosis in the right calcaneus was not significantly different between the three TSH groups,and the incidence of osteoporosis in the left forearm was not significantly different in the three TSH groups.(4)This analysis showed that male TSH levels were positively correlated with BMD of right calcaneus(P<0.05),and had no correlation with BMD of left forearm.The levels of TSH in postmenopausal women was positively correlated with BMD in right calcaneus and left forearm(P<0.05).In the non menopausal women,there was no correlation between TSH levels and BMD of right calcaneus,and TSH levels were not correlated with BMD of left forearm.(5)The BMD group of the right calcaneus and the left forearm as a dependent variable,correction of sex,age,BMI,waist circumference,blood calcium,blood phosphorus,25(OH))D,the binary logistic regression analysis showed that N1 group could increase the risk of osteoporosis than N1 group(OR=2.278,P<0.05)in postmenopausal women.(6)In adult men,postmenopausal women and adult non menopausal women,there was no correlation between TPOAb,TGAb levels with the BMD of left forearm and right calcaneus.Conclusions(1)The normal low levels of TSH(0.39-1.8)m IU/L in male and normal low levels TSH(0.28-2.01)m IU/L in postmenopausal women were more likely to decrease bone density,and the normal TSH levels were positively correlated with BMD.(2)In postmenopausal women,the prevalence of osteoporosis in normal low level TSH(0.28-2.01)m IU/L is increased,and it is an independent risk factor for osteoporosis. |
PDF Full Text Request