Research on the bone metabolism indexes in 112 cases of first diagnosed patients with Graves' disease in Gejiu

doi:10.3877/cma.j.issn.2095-9605.2019.03.004

Abstract

Abstract:

Objective

To investigate the changes of bone metabolic index and their influencing factors in patients with Graves disease (GD) in Gejiu.

Methods

112 cases of patients with newly diagnosed GD in Gejiu were selected. The levels of blood calcium (Ca), phosphorus(P), 25-hydroxy vitamin D[25(OH)D], alkaline phosphatase (ALP), tartrate resistant acid phosphatase (TRACP), parathyroid hormone (PTH), creatinine (Cr) and other indicators were detected. Group comparison was made according to gender, age and 25(OH)D deficiency, and multivariate regression analysis was used to analyze the factors affecting 25(OH)D.

Results

The proportion of 25(OH)D sufficiency, insufficiency, deficiency and severe deficiency in the GD population in Gejiu was 17.86%, 24.11%, 48.21% and 9.82%, respectively. With the decrease of the level of serum 25(OH)D, PTH was significantly increased (P<0.05) .TRACP was highest in the vitamin D insufficiency group and lowest in the severe deficiency group (P<0.05) .The serum levels of 25(OH)D and Cr in female were lower than those in male (P<0.05) . There was no significant difference in the 25(OH)D levels between the patients under 40 years old, those aged 40~60 years, and those over 60 years old (P>0.05) . Blood PTH and Cr of patients under 60 years old were significantly lower than those over 60 years old (P<0.05) . Multivariate linear regression analysis suggested that PTH (B=-7.091, P<0.001) and female (B=-4.999, P<0.001) were negatively correlated with 25(OH)D.

Conclusions

Insufficiency or even deficiency of 25(OH)D is common in GD patients in Gejiu. The level of 25(OH)D in female was lower than that in male. Blood PTH increased with age, and PTH and female were negatively correlated with 25(OH)D. Strengthening the early detection and intervention of bone metabolism indexes in GD patients in this region may be beneficial to the effective prevention and treatment of secondary osteoporosis in GD patients.

Key words: Graves' disease, 25-hydroxy-vitamin D, Calcium, Phosphorus, Parathyroid hormone, Alkaline phosphatase, Tartrate-resistant acid phosphatase

Qian Xiang, Xian Zhang, Xiaorui Yang, Yan Luan, Jing Xu, Xiaohui Ruan, Wanbi Li. Research on the bone metabolism indexes in 112 cases of first diagnosed patients with Graves' disease in Gejiu[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2019, 05(03): 142-147.

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References 23

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组别	年龄（岁）	Ca（mmol/L）	P（mmol/L）	25(OH)D(ng/mL)	PTH（pg/mL）	ALP（mmol/L）	TRACP（IU/L）	Cr（umol/L）
男性（n=30）	43.40±12.39	2.42±0.12	1.34±0.20	25.02±14.58	40.10（28.50，49.15）	110.15±42.33	0.96（0.66，4.12）	64.98±27.97
女性（n=84）	43.54±12.99	2.37±0.12	1.35±0.25	20.22±9.57^a	36.05（25.60，55.28）	108.69±53.58	0.90（0.65，2.49）	44.90±10.23^a
总计（n=112）	43.50±12.77	2.38±0.12	1.35±0.24	21.51±11.26	37.45（25.90，52.07）	109.08±50.63	0.92（0.65，2.49）	50.28±18.99

组别	年龄（岁）	Ca（mmol/L）	P（mmol/L）	25(OH)D(ng/mL)	PTH（pg/mL）	ALP（mmol/L）	TRACP（IU/L）	Cr（umol/L）
男性（n=30）	43.40±12.39	2.42±0.12	1.34±0.20	25.02±14.58	40.10（28.50，49.15）	110.15±42.33	0.96（0.66，4.12）	64.98±27.97
女性（n=84）	43.54±12.99	2.37±0.12	1.35±0.25	20.22±9.57^a	36.05（25.60，55.28）	108.69±53.58	0.90（0.65，2.49）	44.90±10.23^a
总计（n=112）	43.50±12.77	2.38±0.12	1.35±0.24	21.51±11.26	37.45（25.90，52.07）	109.08±50.63	0.92（0.65，2.49）	50.28±18.99

组别	年龄（岁）	Ca（mmol/L）	P（mmol/L）	25(OH)D (ng/mL)
40岁以下（n=42）	30.55±7.29	2.40±0.12	1.39±0.25	21.60±10.54
40~60岁（n=58）	48.29±4.65	2.37±0.11	1.32±0.24	22.23±11.86
60岁以上（n=12）	65.67±6.24	2.35±0.16	1.30±0.14	17.70±10.87
组别	PTH（ pg/mL)	ALP（mmol/L）	TRACP（IU/L）	Cr（umol/L）
40岁以下（n=42）	36.8（26.48，47.60）	119.58±55.71	0.95（0.67，2.49）	45.95±14.15
40~60岁（n=58）	35.30（24.93，51.02）	101.01±48.93	0.95（0.65，3.18）	49.15±11.46
60岁以上（n=12）	55.10（37.80，109.68）^ab	111.34±33.58	0.68（0.57，0.94）	70.87±40.88^ab

组别	年龄（岁）	Ca（mmol/L）	P（mmol/L）	25(OH)D (ng/mL)
40岁以下（n=42）	30.55±7.29	2.40±0.12	1.39±0.25	21.60±10.54
40~60岁（n=58）	48.29±4.65	2.37±0.11	1.32±0.24	22.23±11.86
60岁以上（n=12）	65.67±6.24	2.35±0.16	1.30±0.14	17.70±10.87
组别	PTH（ pg/mL)	ALP（mmol/L）	TRACP（IU/L）	Cr（umol/L）
40岁以下（n=42）	36.8（26.48，47.60）	119.58±55.71	0.95（0.67，2.49）	45.95±14.15
40~60岁（n=58）	35.30（24.93，51.02）	101.01±48.93	0.95（0.65，3.18）	49.15±11.46
60岁以上（n=12）	55.10（37.80，109.68）^ab	111.34±33.58	0.68（0.57，0.94）	70.87±40.88^ab

组别	年龄（岁）	Ca（mmol/L）	P（mmol/L）	25(OH)D (ng/mL)
充足（n=20）	40.10±15.21	2.44±0.10	1.34±0.26	40.69±9.99^bc
不足（n=27）	41.96±10.36	2.40±0.07	1.47±0.22	24.40±2.98^ac
缺乏（n=54）	45.17±12.63	2.35±0.13	1.33±0.21	15.84±2.78^ab
严重缺乏（n=11）	45.27±14.09	2.34±0.18	1.16±0.27^abc	7.37±1.70^abc
?	?	?	?	?
组别	PTH（ pg/mL)	ALP（mmol/L）	TRACP（IU/L）	Cr（umol/L）
充足（n=20）	30.90（17.75，38.70）^bc	120.06±54.14	0.81（0.62，1.04）^bc	51.22±18.70
不足（n=27）	31.70（23.70，48.20）^ac	117.01±59.65	1.22（0.81，5.37）^ac	47.84±13.80
缺乏（n=54）	41.90（28.85，52.75）^ab	98.81±44.20	0.94（0.67，2.79）^ab	51.25±22.51
严重缺乏（n=11）	68.90（39.90，134.00^abc	120.11±46.56	0.94（0.67，2.79）^ab	49.77±11.57

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