갑상선기능항진증에서 $^{99m}Tc-MDP$ 24시간 정체율과 Osteocalcin

24hr Whole-Body Retension of $^{99m}Tc-Methylene$ Diphosphonate and Osteocalcin in patients with Hyperthyroidism

The development of histomorphometric and histodynamic investigations has permitted the description of a specific and complex osteopathy in hyperthyroidism. The increased bone turnover rate in hyperthyroid patients may be accompanied by a considerable bone loss. These features are associated with both inclosed osteoclastic bone resorption and increased osteoblastric bone formation, with an accelerated calcification rate. Conventional biochemical markers of bone metabolism, i.e. serum calcium and alkaline phosphatase and urinary hydroxyproline and calcium are normal in most patients with hyperthyroidism. However, the correlation between serum BGP and serum concentration of thyroid hormon suggests that serum BGP may be a sensitive marker of increased bone formation due to the hypersecretion of thyroid hormones. Any increase in bone turnover, whether focal or diffuse, will result in an increase in $^{99m}Tc-methylenediphosphonate$ uptake (MDP). The measurement of this uptake in hyperthyroid patients by bone provides a sensitive and objective means of quantifying skeletal metabolism. Using a standard shadow-shield whole-body monitor and radioimmunoassay kit, we have measured whole-body retention of $^{99m}Tc-MDP$ up to 24hr and concentration of serum Osteocalcin in 20 patients with hyperthyroidism and in 42 normals. The results were as follows; 1) The average of serum Osteocalcin level in 42 patients with normals was $9.90{\pm}4.87(ng/ml)$ and in 20 patients with hyperthyroidism was $19.54{\pm}5.7(ng/ml)$. Both the averages of serum Osteocalcin and 24hr $^{99m}Tc-MDP$ uptakes in hyperthyroid patients were higher than those in normals. 2) $^{99m}Tc-MDP$ uptakes in skeletal system increased in proportion to normal ageing after 40 yrs old in 42 patients with normals. The average of $^{99m}Tc-MDP$ uptakes in hyperthyroid patients were higher than those in normals without related ageing. 3) A significant relationships between the $^{99m}Tc-MDP$ uptakes and serum Osteocalcin level were peformed (r=0.55, $y=17.58+6.7\times$). From the above results we concluded that the measurement of serum Osteocalcin and 24hr $^{99m}Tc-MDP$ uptakes can be used for evaluation of bone turnover as a specific marker in hyperthyroid patients.