The Study Of Relationship Between Thyroid Hormone Levels And Bone Content In Patients Of Hyperthyroidism Before And After131I Therapy

Obiective To research the relationship between changes of thyroid hormone levels and bone content in patients of hyperthyroidism before and after131I therapy.Methods69cases with hyperthyroidism were divided into4groups:the cure group, improved group, hypothyroidism group, inactive group according to the curative effect3months and6months affter131I therapy, of which3months after treatment for24cases of each group,19,14and12patients,6months after each case numbers34,10,18and7cases. The bone mineral density(BMD) in ward’s triangle, femur neck, and greater torchanter of femur, L2, L3and L4were obtained by dual-energy X-rays absorptiometry(DEXA) in69cases with hyperthyroidism before and after131I therapy and30controls respectively. The serum levels of FT3、FT4、TSH of69patients with hyperthyroidism were measured before and after131I therapy. Matched-pairs t-test and independent-sample t-test were used. The longitudinal analysis for each variable was achieved by comparing the mean value by the paired-sample t-test.Results (1) BMDs of ward’s triangle and greater torchanter of femur, L2, L3and L4in the patients and the control were0.832±0.150,0.812±0.113,1.162±0.160,1.198±0.157,1.184±0.170g/cm2and0.960±0.123,0.919±0.109,1.256±0.111,1.299±0.105,1.292±0.117g/cm2respectively(t=2.932-4.395, p<0.05).(2)3months affter131I therapy:BMDs of ward’s triangle and greater torchanter of femur, L2, L3and L4in the cure group0.842±0.148,0.829±0.116,1.162±0.138,1.195±0.150,1.185±0.173g/cm2and BMDs of ward’s triangle and greater torchanter of femur, L3and L4in the improved group0.806±0.176,0.769±0.127,1.209±0.187,1.188±0.202g/cm2before therapy significantly decreased(t=2.156-4.390,p<0.05). BMDs of greater torchanter of femur, L2,and L3in the cure group0.891±.256,1.190±0.154,1.231±0.171g/cm2and BMDs of L3in the improved group1.218±0.186g/cm2had improved after therapy.(t=0.539-1.960,p>0.05). BMDs of L4in the hypothyroidism group1.195±0.113was lower than the corresponding part in contorl group after therapy(t=2.274,p=0.028). BMD of ward’s triangle and greater torchanter of femur, L,2,L3and L4in inactive group before and after131I therapy was significantly lower than that in the contorl, the different were significant (t=2.363～3.494,p<0.05).(3)6months affter131I therapy:BMDs of ward’s triangle and greater torchanter of femur, L2, L3and L4in the cure group0.817±0.164,0.793±0.116,1.155±0.159,1.204±0.173,1.182±0.184g/cm2, BMDs of ward’s triangle and greater torchanter of femur in the improved group0.847±0.183,0.825±0.147g/cm2, BMDs of ward’s triangle and greater torchanter of femur, L2, L3and L4in the hypothyroidism group0.856±0.123,0.832±0.089,1.156±0.120,1.181±0.107,1.184±0.118g/cm2, were lower than corresponding parts in contorl group before therapy(t=2.150～4.496, p<0.05).Only BMD of L3in the cure group was no improvement after6months therapy (t=2.351,p=0.022).BMD of ward’s triangle and greater torchanter of femur, L,2,L3and L4in inactive group had no improvement after after6months therapy(t=2.207～2.847, p<0.05).(4) The improvement of six6months better than3months after therapy(p<0.05),91.667%(11/12) versus44.4%(4/9)Conclusion BMDs of patients with hyperthyroidism were lower than normal people. An early contorl of the disease is of great significance in the prevention of osteoporosis. BMDs of hyperthyroidism patients can resume to normal in a short period of time after I therapy with the recovery of thyroid hormone levels, and the number of improving sites will increase along with the extension of time.But the speed lag behind the thyroid hormone levels,clinical symptoms and physical signs. Therefore, this study suggests that patients should be added calcium, phosphate preparations and D agent to accelerate the improvement of BMDs before and after131I therapy.