On Thyroid Function And Bone Mineral Density In Postmenopausal Women

Objective To explore the relationship between thyroid function and bone mineral density(BMD)in postmenopausal women.Methods According to the Chinese Patients with Type 2 Diabetes Cancer Risk Epidemic Studies from August 2011 to December 2011 which was held in Dalian Hospital Center by Chinese Medical Association,a total of 10,207 patients were enrolled.They were collecting age,sex,menstrual history,medication history,chronic history and thyroid disease,the weight,waist circumference,hip circumference,systolic blood pressure,diastolic blood pressure and heart rate were measured.They were tested in serum free thyroxine(free triiodothyronine,FT3),serum free thyroxine(free triiodothyronine,FT3),serum free thyroxine Free thyroxine(FT4),thyroid stimulating hormone(TSH),thyroid peroxidase antibodies(TPOAb),thyroglobulin antibodies(TGAb),blood lipids,fasting plasma glucose(FPG),2 hours postprandial blood glucose(2hPBG),and dual-energy X-ray absorptiometry were used to determine the lumbar spine 1-4(lumbar spinel-4,L1-4)BMD,calculated BMD-T value;and thyroid ultrasonography.According the selection and exclusion criteria,339 postmenopausal women were selected from the community residents.According to the TSH trichotaminization level,they were divided into T1,T2 and T3 group,compared the groups of bone mineral density and bone abnormalities of the prevalence rate.Spearman correlation analysis and binary logistic regression model were used to analyze the relationship between thyroid function and BMD-T value of lumbar vertebrae.Results1.There was significant difference in BMD-T between T2 group and T1 group,T3 group and T1 group(Z =-2.519,P=0.012;Z =-2.345,P=0.019)(Z =-1.000,P =0.921).In addition,T2 group and T1 group age difference,T3 group and T1 group TG difference(P<0.05),menarche age,menopause age,menopause age,BMI,waist circumference,SBP,DBP,FPG,2hPBG,HDL-There were no significant differences in LDL-C,TC,FT3 and FT4 groups(F were 0.128,0.515,2.420,1.103,0.038,0.130,0.520,respectively,and the chi-square values were 3.521,4.652,0.159,0.324,1.669,1.273,2.270,P>0.05).2.Of the 339 subjects,133 were normal bone mass,159 were osteopenia,47 were osteoporosis,and 206 had abnormal bone mass.The prevalence of bone abnormality was 60.76%.The prevalence of bone mass abnormality was 72.82%in T1 group,57.05%in T2 group,54.94%in group T3.T2 group and T1 group,T3 group and T1 group have significant differences(?~2=6.171,P = 0.013;?~2 =6.344,P = 0.012).The prevalence of bone abnormality in group T1 was 2.018 times higher than that in group T2(OR = 2.018,95%CI 1,155-3.525).The prevalence of bone abnormality in group T1 was 2.198 times higher than that in group T3(OR = 2.198,95%CI 1.185-4.076).There was no significant difference between the T3 group and the T2 group(?~2=0.104,P = 0.748).3 Spearman correlation analysis showed that lumbar spine BMD-T was negatively correlated with FT4(r =-0.112,P = 0.039),positively correlated with TSH(r = 0.139,P = 0.010),and no correlation with FT3(r = 0.022,P = 0.693).Lumbar spine BMD-T was negatively correlated with age and menopause years(r =-0.236,P=0.000;r =-0.256,P= 0.000),and positively correlated with BMI,DBP and TG(r =0.175,P = 0.000;r = 0.129,P = 0.000,r = 0.146,P = 0.007).Lumbar spine BMD-T has no correlation with menarche age,menopause age,waist circumference,SBP,FPG,2hPBG,HDL-C,LDL-,TPOAb and TGAb(P>0.05).4.In the survey population,whether or not the bone loss was the dependent variable,TSH was the independent variable,and the binary logistic regression analysis showed that increase of one standard deviation of TSH,the risk of bone loss was increased 78.1%(OR = 0.781,95%CI 0.622-0.980,P<0.05)without correcting any confounding factors.The risk of abnormal bone loss was 78.6%(OR = 0.786,95%CI 0.623-0.992,P<0.05)after adjusting for age,menopause,BMI,DBP and TG.In addition,BMI was a protective factor of bone abnormality(OR = 0.895,95%CI 0.833-0.960,P<0.05).Menopause was a risk factor for bone abnormalities(OR = 1.073,95%CI 1.036-1.111,P<0.05).Conclusions1.With the increase of TSH,the prevalence of bone abnormalities is gradually decreasing trend;2.TSH is an independent protective factor for postmenopausal women with abnormal bone mass.