Risk Assessment Of Fracture In Postmenopausal Women Within Normal Serum TSH

Objective:After underwent measurement the bone mineral density by DXA,we intend to find the relationship between TSH, TPOAb, TGAb and fracture risk within normal serum TSH in postmenopausal women. Investigate the normal TSH change with fracture risk in postmenopausal women.Explore the possible risk factors for osteoporosis and osteoporotic fracture, so as to provide a theoretical basis for the treatment of postmenopausal women with abnormal thyroid function.Methods:1.Subjects:collected the patients with standard from the First Hospital of Shanxi Medical University, Department of Endocrinology, March 2015 to February 2016.2.Subjects all measured TSH, TPOAb, TGAb, FBG, 2h PBG, Hb A1 c, TG, TC,LDL-C, HDL-C and UA,also the bone mineral density(1-4 lumbar spine and left hip).3.According to the serum TSH values we were screened again,subjects with the normal serum TSH were included in(normal range of serum TSH: 0.27- 4.20 u IU/m L).Used of all datas to calculate the risk of fracture by FRAX○R in Asia-China,the tool which the WHO recommended.4.Used of V18.0 SPSS for statistical analysis, measurement data be expressed by mean ± standard deviation, the count data be expressed by case and percentage(n,%).Using single factor analysis of variance and covariance analysis, P < 0.05 indicated that there was statistical significance.Results:1.After entering the standards and exclusion criteria, a total of 166 postmenopausal women were included.In those people there were 54 women with osteoporosis(32.5%),66 women got bone loss(39.8%),and only 46 women have the normal bone mass(27.7%).2.According to serum TSH levels were divided subjects into three groups: Q1(0.325-2.15 u IU/m L, 55), Q2(2.16-3.46 u IU/m L, 55) and Q3(3.47-4.2u IU/m L, 56),There were 22 women with osteoporosis,21 osteopenia people and 12 women with normal bone massin in group Q1;Group Q3 with 12 women got osteoporosis, 27 women have osteopenia and 17 people got normal bone mass.3.In the normal range,serum TSH was negatively correlated with menopause year,the main part of fracture risk, and risk of hip fracture. And positively correlated with BMD of the lumbar spine. There were no correlation between TSH within normal range and lumbar BMC, BMC and BMD of the hip. Serum TPOAb negatively correlated with lumbar bone area, BMC and BMD.Serum TGAb positively related to hip bone area and BMC.4.According to serum TSH, TPOAb and TGAb concentration in women with normal thyroid function, we divided into three groups, adjusting for age,menopause year and body mass index(BMI),we can find the relationship between TSH and the main fracture risk,risk of hip fracture and hip BMC in normal range of serum TSH value.TSH has nothing to do with lumbar spine BMD and hip BMD.Different concentration of TPOAb was related to lumbar spine BMD and BMC,while was nothing to do with the main parts of the fracture risk and hip fracture risk and BMD.There were no relationship between TGAb and fracture risk and BMD.Conclusion:1.The longer menopausal year women have,the lower TSH value within the normal range.The lower TSH value in the normal range, the more reduction of lumbar spine BMD and the incidence of major parts and the higher risk of hip fracture.2.When TPOAb in postmenopausal women with normal TSH increasing,the lumbar BMC and BMD decreasing.3.There was no significant correlation between serum TGAb and BMD and fracture risk in postmenopausal women with normal serum TSH.