The Impact Of Abnormal Thyroid Function On Bone Mineral Density Of Lumbar Spine And Proximal Femur

Objective:To investigate the effect of abnormal thyroid function on the bone mineral density(BMD)of the lumbar spine and proximal femur.Methods:This article is a cross-sectional study,including 983 subjects,collecting thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free tetraiodothyronine(FT4),BMD and other related factors.clinical information.According to thyroid function,they were divided into normal group and abnormal group(hyperthyroidism group,hypothyroidism group,subclinical hyperthyroidism group and subclinical hypothyroidism group),and subgroup analysis was made according to gender.Analysis of variance and t test were used to evaluate the differences between groups,and regression analysis was used to explore the effect of abnormal thyroid function on BMD in different parts.Results:1.The BMD of the lumbar spine in the women with abnormal thyroid function was lower than that in the normal group(P<0.05),and the BMD of the proximal femur in the hypothyroidism group was lower than that in the normal group(P<0.05).2.Multivariate linear regression analysis showed that in the hyperthyroidism group,female FT4 and FT3 were risk factors for lumbar spine BMD decline;male TSH was a protective factor for lumbar spine and bilateral femoral BMD decline,FT4 was a protective factor for bilateral femoral BMD decline.FT3 was a protective factor for left femur BMD decline(P<0.05).In the subclinical hyperthyroidism group,TSH was a protective factor for lumbar spine BMD decline;female FT4 was a risk factor for lumbar spine BMD decline,and male FT4 was a risk factor for lumbar spine and right femur BMD decline(P<0.05).In the hypothyroid group,FT4 was a protective factor for lumbar spine BMD decline;female FT3 was a risk factor for lumbar spine BMD decline,and male TSH was a risk factor for lumbar spine and bilateral femoral BMD decline(P<0.05).In the subclinical hypothyroidism group,FT4 was a protective factor for lumbar spine BMD decline;female TSH was a risk factor for lumbar spine and bilateral femoral BMD decline,and male FT4 was a protective factor for lumbar spine and bilateral femoral BMD decline(P<0.05).Conclusions:1.The effect of abnormal thyroid function on the bone mineral density of different parts is not completely consistent,and the effect on the lumbar spine is more obvious.2.In hyperthyroid patients,elevated FT4,FT3 and decreased TSH are risk factors for decreased bone mineral density.3.In patients with hypothyroidism,decreased FT4,FT3 and increased TSH are risk factors for decreased bone mineral density.