二次性甲状腺功能障碍症:预测因素和与维生素D状况,骨周转标志物和骨矿物质密度的关系
Donal Fitzpatrick1, Eamon Laird2, Mary Ward3
1Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland; School of Medicine, Trinity College, Dublin, Ireland.
Bone
|April 20, 2024
概括
二次性偏甲状腺症 (SHPT) 影响到六分之一的爱尔兰老年人,与较低的骨矿物质密度 (BMD) 和较高的骨周转标志物有关. 维生素D缺乏是关键预测因素,强调了对这一群体进行监测和干预的必要性.
科学领域:
- 老年学是一门学科.
- 内分泌学 在内分泌学.
- 骨的新陈代谢 骨的新陈代谢
背景情况:
- 二次性偏甲状腺症 (SHPT) 对骨健康产生负面影响,在老年人群中研究不足.
- 需要进一步调查SHPT的患病率,决定因素和骨健康关联.
研究的目的:
- 确定爱尔兰老年人中SHPT的患病率和预测因素.
- 检查SHPT,骨循环标记物和骨矿物质密度 (BMD) 之间的关系.
主要方法:
- 来自TUDA研究的4139名年龄≥60岁的爱尔兰成年人的分析.
- 排除了患有晚期CKD (eGFR<30毫升/分钟) 或原发性副甲状腺炎症 (血清>2.5毫摩尔/升) 的参与者.
- 在亚样本 (n=1488) 中,评估SHPT与维生素D水平,功能,药物使用,骨周转标记物和骨质量相关的评估.
主要成果:
- 在维生素D缺乏个体中,SHPT的患病率为30.6%,并且随着25-氧维生素D[25(OH) D]水平的增加而降低.
- SHPT的主要决定因素包括维生素D缺乏,降低的eGFR和循环利尿剂的使用.
- SHPT与较高的骨转化标记物 (骨性酸酸酶,耐酸酸酸酶) 和较低的腿部部和整个部的BMD相关.
结论:
- 大约六分之一的老年爱尔兰成年人表现出SHPT,与较差的骨健康指标相关.
- 维生素D缺乏和30-49nmol/l之间的水平是SHPT的显著预测因素.
- 循环利尿剂和质子抑制剂 (PPI) 可能会增加SHPT风险,因此在这个人口群体中需要仔细考虑.
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