A Preliminary Study Of Changes In Bone Metabolism During Comprehensive Therapy In Postoperative Patients With Differentiated Thyroid Carcinoma

Objective To explore the relations between the bone mineral density change and related bone metabolism index of postoperative patients with differentiated thyroid carcinoma(DTC) who have been through 131 I treatment and levothyrocine suppressive therapy.Methods Chose 70 cases of postoperative patients with differentiated thyroid carcinoma(DTC) as treatment group who have been through 131 I treatment and levothyrocine suppressive therapy from Nuclear Medicine Department of Fujian Provincial Hospital in 2014, including 20 males and 50 females aging from 19 to 72, whose average age is 45.44±11.46. Among them, the average age of the female is 43.62±10.685, and the average age of the male is 50.00±12.342. And then chose 70 cases of normal people as control group, including 22 males and 48 females aging from 25 to 70, whose average age is 48.24±8.539. Among them, the average age of the female is 47.58±8.894, and the average age of the male is 49.68±7.705. The differences of the gender, age and the body mass index(BMI) of the two groups had no statistical significance(P?0.05). According to the medical history, PTH and the blood calcium, the treatment group was divided into normal parathyroid function group(group A) and hypoparathyroidism group(group B). Bone mineral density and bone biochemical metabolism index was observed in the treatment group, including the blood calcium(Ca2+), phosphorus(P), parathyroid hormone(PTH), calcitonin(CT), beta collagen specific sequences(beta-CTX), total collagen special sequence of type I collagen amino end extending peptide(t PINP), etc. Bone mineral density was observed in the normal group. The bone mineral density was measured by dual-energy X-ray absorptiometry(DEXA)(OSTEOCORE – 2) from France Medilink. The study used SPSS 20.0 to process data, including T-test and chi-square test, and linear correlation analysis.Results The BMD, the T value and the Z value between the treatment group and the control group had no significant statistical difference(P ?0.05); the mean value of Lumbar Z value, T value of group A was lower than group B(P ? 0.05), and the mean Z value and T value of the femoral neck had no obvious difference between the two groups(P ? 0.05); blood calcium was negatively related to the lumbar BMD in the treatment group(r =-0.237, P = 0.049); PTH and Ca2 + was positive correlation(r = 0.513, P = 0.000), and was negatively related to the value of phosphorus(r =-0.582, P = 0.000); beta-CTX was negatively related to lumbar BMD(r =-0.487, P = 0.018); some patients' beta-CTX in treatment group was obviously lower than the upper limit value of premenopausal women(P = 0.000), but the t PINP had no obvious difference from upper limit value of premenopausal women(P = 0.409); In the treatment group, 46/47 patients'(97.9%) CT value was less than 0.500 pg/ml.Conclusions Postoperative patients with DTC who have been through 131 I treatment and levothyrocine suppressive therapy have no significant changes in the bone mineral density in a short term, and the serological data implies that its bone formation is in dominant. The bone mineral density of hypoparathyroidism group was higher than that of normal parathyroid function group(group A), suggesting that low level of PTH promots bone formation and inhibits bone absorption.