Changes Of Serum IL-17 Concentration In Newly Diagnosed Female Graves Disease Patients With Abnormal Bone Mass

Objective:To explore the change of the serum IL-17 concentration and its possible effcct on bone metabolism in patients with Graves’ disease by detecting the levels of IL-17,t P1 NP,?-Cross Laps,N-MID, Ca, P, E2, FSH, LH, and analyzing the relationship between IL-17 and FT3, FT4, TSH levels,bone mineral density in newly diagnosed Graves disease patients with abnormal bone mass.Methods:57 female newly diagnosed and untreated GD patients were involed in the hyperthyroidism group,divided into 31 pre-menopausal patients,26 post-menopausal women. According to WHO classification of osteoporosis by the T /Z scores of BMD(in postmenopausal women with T score, premenopausal women with Z score) Graves patients were divided into osteoporosis group(T/Z <-2.5), osteopenia group(-1.0> T/Z >-2.5), the normal bone mass group(-1< T/Z< 1) three subgroups.46 cases as control group,(age, gender, and the case group were matched healthy subjects),including 18pre-menopausal women, 28 post-menopausal women.All cases were measured height,weight, body mass index.IL-17 were measured using ELISA method.β-Cross Laps,NMIDOCN,t P1 NP were measured using ECLI method.Chemiluminescence method for the determination of E2, FSH, LH.Automatic biochemical analyzer detection of blood Ca,P, FPG, TC, TG, HDL, LDL levels.Bone mass of the patients were detected using duelenergy X-ray absorptiometry.And analyzed the relationship between IL-17 and FT3, FT4,TSH levels,bone mineral density in newly diagnosed Graves disease patients with abnormal bone mass.Results:1. There was no significant difference in age, body mass index between GD women and the control group, TC, TG, LDL, HDL levels decreased(P<0.05, P <0.01); the level of FPG increased(P<0.05); compared with the control group,postmenopausal women patients with GD the levels of FSH, LH, E2 increased(P<0.05); FT3, FT4 were significantly increased, TSH decreased(P<0. 01); compared to healthy subjects, female Graves patients IL-17 increased(P<0.05),N-MID OCN,t PINP, β-Cross Laps was significantly increased(P<0.05, P<0.01), The BMD at femoral neck and distal radius 1/3were lower than healthy women,especially at distal radius, But L1-4 BMD in postmenopausal women in the hyperthyroid patients were significantly lower than in control group(P<0.05), there were no differences of L1-4 BMD between pre-menopausal patients with hyperthyroidism and the control group.2. whether suffering from Graves’ disease, compared with the pre-menopausal,post-menopausal women BMI were higher(P<0.05);TC,TG,LDL increased;there were no differences in HDL between pre-menopausal patients with hyperthyroidism and the post-menopausal patients with hyperthyroidism;In healthy postmenopausal women the HDL decreased, N-MID OCN,t PINP, β-Cross Laps increased(P<0.05).The BMD at femoral neck,distal radius 1/3 and L1-4 deceased(P <0.05).3. Post-menopausal women dived into three subgruops by bone density T / Z score,IL-17,t P1 NP,β-Cross Laps and N-MID OCN were significantly higher in osteoporosis group than in osteopenia group and normal BMD group.IL-17,t P1 NP,β-Cross Laps and N-MID OCN were significantly higher in osteopenia group and normal BMD group(P<0.05, P <0.01).4. Female patients with Graves disease were dived into three subgruops by bone density T / Z score,IL-17,t P1 NP,β-Cross Laps and N-MID OCN were significantly higher in osteoporosis group than in osteopenia group and normal BMD group.IL-17,t P1 NP,β-Cross Laps and N-MID OCN were significantly higher in osteopenia group and normal BMD group(P<0.05, P <0.01).5. The correlation analysis showed that IL-17 positively correlalated with FT4 and FT3,(r=0.491,r=0.492;p<0.05),negatively correlalated with TSH(r=-0.462,P<0.05),positively correlalated with β-Cross Laps(r=0.473,P<0.05);negatively correlated with1/3 radial and femoral neck BMD(r=-0.501,r=-0.502;P<0.05,no correlation with L1-4BMD, N-MID OCN,and t P1 NP.Conclusions:1. The level of IL-17 increased significantly in patients with Graves disease in women,and positively related with thyroid hormone, and negatively correlated with TSH,indicating that there is some correlation between changes of thyroid function,and may be involved in the development of Graves disease.2. The level of serum IL-17 was positively related with β-Crosslaps, had no significant correlationwith N-MIDOCN and t P1 NP,indicating that IL-17 may increased bone resorption, involved in decreased bone mass in patients, particularly in the forearm1/3 obvious.3. The level of IL-17 was significantly increased in post-menopausal women, and has some correlation with lower bone mineral density, indicating that it may be involved in the occurrence and development of postmenopausal osteoporosis.