| Objective:To investigate the correlation between the course of Hashimoto’s thyroiditis,thyroid stimulating hormone(TSH),anti-thyroid peroxidase antibody(TPOAB),anti-thyroglobulin antibody(TGAB),nutrophils-lymphocytes ratio(NLR)and bone mineral density in postmenopausal patients with normal thyroid function.Methods:1.A total of 192 female patients with Hashimoto’s thyroiditis who were admitted to the geriatric department or internal medicine department of our hospital from May 2019 to December 2020 meeting the inclusion criteria and exclusion criteria were selected,and 192non-Hashimoto’s thyroiditis female patients whose baseline level of internal medicine hospitalization during the same period was equivalent to the observation group were selected.2.Clinical data of the above two groups were collected,including:Age,menopausal age,body mass index(BMI),fasting blood glucose,blood routine,liver function,renal function,blood triglycerides,cholesterol,estradiol,serum 25(OH)D3,alkaline phosphatase and osteocalcin,blood calcium and blood sodium,blood phosphorus and free thyroxine(FT4),free three iodine glycine(FT3),TSH,thyroid TPOAb,TGAB,NLR,bone mineral density of lumbar spine,femoral neck,Wards greater triangle,femoral trochanter and femoral shaft,T value of lumbar spine and femoral neck.3.The differences in general indexes,thyroid function indexes and bone mineral density between Hashimoto thyroiditis patients and non-Hashimoto thyroiditis patients were compared and analyzed,and the proportion of osteoporosis between the two groups was analyzed.4.Hashimoto thyroiditis patients were divided into osteoporotic group and non-osteoporotic group.The general indexes,thyroid function indexes,bone metabolism indexes and bone mineral density between the two groups were analyzed to screen out the factors with differences.5.All data were analyzed by statistical software SPSS 25.0.Non-normally distributed antibody data is normally converted.All data were analyzed by t test andχ2 test were used to compare the differences.Bivariate correlations are described using Person correlations.In the multivariate analysis,the Logistic regression equation model was established,and all test levels wereα=0.05 on both sides.Results:1.Hashimoto thyroiditis group and control group in age,menopausal age,BMI,TC,TG,Hb A1c,Scr,Glu,ALT,AST,blood calcium,25(OH)D3,CRP,ALP,estradiol,osteocalcin by two independent sample t-test results showed that,there were no statistically significant differences(P>0.05).TSH,TPOAb,TGAb and NLR in Hashimoto group were significantly higher than those in non-Hashimoto group,with statistical significance(P<0.05).2.t-test analysis between the Hashimoto thyroiditis group and the control group showed that Bone mineral density of all parts was lower than that of non-Hashimoto thyroiditis group.T-lumbar vertebrae(-0.95±1.6)and T-femoral neck(-1.19±1.36)in the Hashimoto thyroiditis group were significantly different from those in the non-Hashimoto thyroiditis group(P<0.05).The proportion of osteoporosis was 28.13%in patients with Hashimoto’s thyroiditis and15.63%in patients without Hashimoto’s thyroiditis.The proportion of osteoporosis in patients with Hashimoto’s thyroiditis was significantly higher than that in patients without Hashimoto’s thyroiditis.χ~2=8.777,the differences were statistically significant(P<0.01).3.Hashimoto thyroiditis osteoporosis in osteoporosis patients with age,menopausal age,BMI,TC,TG,Hb A1c,Scr,Glu,ALT,AST,ALP,blood calcium,25(OH)D3,CRP,estradiol,osteocalcin by two independent t-test results of the samples showed that there was no statistical significance in the differences(P>0.05).In the Hashimoto thyroiditis group,the course of disease and NLR of osteoporosis patients(5.24±3.97)were significantly higher than those of non-osteoporosis patients(2.00±1.03).In addition,Lg(TPOAb)of osteoporosis patients was significantly higher than that of non-osteoporosis patients,the difference was statistically significant(P<0.05).4.T-value of femoral neck in Hashimoto’s thyroiditis group was negatively correlated with age and menopausal years(R=-0.174,R=-0.229).BMD-lumbar spine(R=-0.198),BMD-femoral neck(R=-0.178),BMD-Ward triangle(R=-0.153),BMD-greater trochanter(R=-0.171),BMD-femoral shaft(R=-0.157),lumbar T value(R=-0.157),T value of femoral neck(R=-0.164)was negatively correlated with the course of Hashimoto.BMD-lumbar vertebra(R=-0.214),BMD-femoral neck(R=-0.235),BMD-Ward triangle(R=-0.230),BMD-greater trochanter(R=-0.301),BMD-femoral shaft(R=-0.204),T-lumbar vertebra(R=R=-0.168),T-femoral neck(R=-0.237)were negatively correlated with NLR,and the difference was statistically significant(P<0.05).BMD-greater trochanter(R=-0.148),BMD-femoral shaft(R=-0.155)were negatively correlated with LG(TPOAB),TSH was positively correlated with BMD-femoral neck(R=0.166)and Wards triangle(R=0.187),and the differences were statistically significant(P<0.05).5.Logistic analysis showed that TSH was an independent protective factor for the incidence of osteoporosis in Hashimoto’s thyroiditis(OR=0.959),Hashimoto’s disease course(OR=1.147)and NLR(OR=2.848)were independent risk factors for the incidence of osteoporosis in Hashimoto’s thyroiditis,and the difference was statistically significant(P<0.01).Conclusion:1.Among postmenopausal women,the proportion of osteoporosis in patients with Hashimoto’s thyroiditis is increased.2.Age,menopausal years,BMI,TSH,TPOAb and NLR were correlated with bone mineral density indexes,but no significant correlation was found with TGAb.3.Hashimoto’s disease course and NLR are independent risk factors for osteoporosis. |
