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갑상선기능이 정상인 성인에서 골다공증과 갑상선호르몬의 관련성

The association of Osteoporosis and Thyroid Hormone in euthyroid adults

  • 윤현 (한려대학교 임상병리학과) ;
  • 류은진 (한려대학교 간호학과)
  • Yoon, Hyun (Department of Biomedical laboratory science, Hanlyo University) ;
  • Ryu, Eun-Jin (Department of Nursing, Hanlyo University)
  • 투고 : 2014.09.30
  • 심사 : 2015.02.12
  • 발행 : 2015.02.28

초록

본 연구는 일부 종합검진 수검자들을 대상으로 골다공증이 갑상선호르몬에 미치는 영향을 검토하고자 2012년 1월부터 12월까지 G시의 일개 종합병원 건강검진센터에서 종합건강검진을 받았던 20세 이상의 지역주민 1,117명(남자 636, 여자 481)을 분석대상으로 하였다. 연구결과에서 연령과 성별을 보정하였을 때, 갑상선자극호르몬(thyroid stimulating hormone)에 대한 평균값은 정상군(${\geq}-1g/cm^2$)이 $1.61{\pm}0.07{\mu}IU/m{\ell}$, 골감소증군(-1 >, ${\geq}-2.5g/cm^2$)이 $1.82{\pm}0.08{\mu}IU/m{\ell}$, 골다공증군(< $-2.5g/cm^2$)이 $3.14{\pm}0.27{\mu}IU/m{\ell}$로 T-score가 감소할수록 증가하였다(p<0.001). 또한 성별과 FBS를 보정하였을 때, 유리타이록신(free thyroxine)에 대한 평균값은 정상군이 $1.30{\pm}0.01ng/d{\ell}$, 골감소증군이 $1.22{\pm}0.01ng/d{\ell}$, 골다공증군이 $1.13{\pm}0.04ng/d{\ell}$로 T-score가 감소할수록 감소하였다(p<0.001). 결론적으로 갑상선기능이 정상인 성인에서 T-score의 감소는 갑상선 자극호르몬(thyroid stimulating hormone)를 증가시키고, 유리 타이록신(free thyroxine)를 감소시킨다.

This study examined the impact of osteoporosis on thyroid hormone in health check-up examinees. The study subjects were 1,117 adults, 20 years and over (636 males, 481 females), who underwent a health package check-up at the general hospital G from January to December, 2011. After adjusting for factors, such as year and gender, the mean thyroid stimulating hormone increased with decreasing T-score (Normal[${\geq}-1g/cm^2$], $1.61{\pm}0.07{\mu}IU/m{\ell}$ and osteopenia[-1 >, ${\geq}-2.5g/cm^2$],$1.82{\pm}0.08{\mu}IU/m{\ell}$ and osteoporosis[< $-2.5g/cm^2$],$3.14{\pm}0.27{\mu}IU/m{\ell}$). After adjusting for factors, such as gender and FBS, the mean free thyroxine decreased with decreasing T-score(Normal, $1.30{\pm}0.01ng/d{\ell}$, and osteopenia, $1.22{\pm}0.01ng/d{\ell}$, and osteoporosis, $1.13{\pm}0.04ng/d{\ell}$). Conclusion. These results suggest that a decrease in T-score might increase the thyroid stimulating hormone and decrease the free thyroxine levelin euthyroid adults.

키워드

참고문헌

  1. Sranley. L. R, Ramzi. S. C and Vinay. K, "Pathologic Basis of Disease, 3rd ed. Philadelphia", WB Saunder, pp.1203, 1984
  2. Y. W. Cho, "Clinical Implication of Serum TSH Concentration", Journal of Korean society of endocrinology, Vol.22, No.2, pp.87-94, 2007 DOI: http://dx.doi.org/10.3803/jkes.2007.22.2.87
  3. Watofsky. L and Dicky. R. A, "The evidence for anarrower thyrotropin reference range", The Journal of Clinical Endocrinology & Metabolism, Vol.90, No.9, pp.5483-5488, 2005 DOI: http://dx.doi.org/10.1210/jc.2005-0455
  4. Baloch. Z, Carayon. P, Conte-Devolx. B, Demers. L. M, Feldt-Rasmussen. U, et al., "Guidelines Committee, National Academy of Clinical Biochemistry. Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monitoring of thyroid disease", Thyroid, Vol.13, No.1, pp.123-126, 2003
  5. Nicoloff. J. T and Spencer. C. A, "The use and misuse of the sensitive thyrotropin assays", The Journal of Clinical Endocrinology & Metabolism, Vol.71, No.3, pp.553-558, 1990 DOI: http://dx.doi.org/10.1210/jcem-71-3-553
  6. Bernadette. B, Emiliano. A. P, Serafino. F, Carmela. C, Maria. N, et al., "Endogenous Subclinical Hyperthyroidism Affects Quality of Life and Cardiac Morphology and Function in Young and Middle-Aged Patients", The Journal of Clinical Endocrinology & Metabolism, Vol.85, No.12, pp.4701-4705, 2007 https://doi.org/10.1210/jc.85.12.4701
  7. Caroline. S. F, Michael. J. P, Ralph. B. D, Joanne. M. M, Ellen. W. S, et al., "Relations of Thyroid Function to Body Weight: Cross-sectional and Longitudinal Observations in a Community-Based Sample", Archives of Internal Medicine, Vol.168, No.6, pp.587-592, 2008 DOI: http://dx.doi.org/10.1001/archinte.168.6.587
  8. Empson. M, Flood. V. M, Eastman. C. J and Mitchell. P, "Prevalence of thyroid disease in an older Australian population", Internal Medicine Journals, Vol.37, No.7, pp.448-455, 2007 DOI: http://dx.doi.org/10.1111/j.1445-5994.2007.01367.x
  9. Michael. J. K, Daniel. E. F, Lucy. A. M, Jiang. H, Paul. K. W, et al., "Serum cholesterol in young men and subsequent cardiovascular disease", New England Journal of Medicine, Vol.328, No.5, pp.313-318, 1993 DOI: http://dx.doi.org/10.1056/NEJM199302043280504
  10. K. W. Oh, "Diabetes and osteoporosis", Korean Diabetes Journal, Vol.33, pp.169-177, 2009 DOI: http://dx.doi.org/10.4093/kdj.2009.33.3.169
  11. Avioli. L. V, "The osteoporotic syndrome Detection, prevention and treatment. 4th ed", Orlando, FL: Academic press, 2000.
  12. M. S. Kim and J. O. Koo, "Comparative analysis of food habits and bone density risk factors between normal and risk women living in the seoul area", Korean Journal of Community Nutrition, Vol.13, No.1, pp125-133, 2008
  13. Metz. J. A, Anderson. J. B and Gallagher. Jr. P. N, "Intakes of calcium, phosphorus, and protein and physical activity level are related to radial bone mass in young adult women", American Journal of Clinical Nutrition, Vol.58, pp.537-542, 1993 https://doi.org/10.1093/ajcn/58.4.537
  14. Amato. G, Mazziotti. G and Sorvillo. F, " High serum osteoprotegerin levels in patients with hyperthyroidism: effect of medical treatment", Bone, Vol.35, No.3, pp.785-791, 2004 DOI: http://dx.doi.org/10.1016/j.bone.2004.04.021
  15. Persani. L, Terzolo. M, Asteria. C, Orlandi. F, Angeli. A and Beck-Peccoz. P, "Circadian variations of thyrotropin bioactivity in normal subjects and patients with primary hypothyroidism", The Journal of Clinical Endocrinology & Metabolism, Vol.80, pp.2722-2728, 1995 DOI: http://dx.doi.org/10.1210/jc.80.9.2722
  16. Scobbo. R. R, von Dohlen. T. W, Hassan. M and Islam. S, "Serum TSH variability in normal individuals: the influence of time of sample collection", West Virginia Medicine Journal, Vol.100, pp.138-142, 2004
  17. Konno. N and Morikawa. K, "Seasonal variation of serum thyrotropin concentration and thyrotropin response to thyrotropin releasing hormone in patients with primary hypothyroidism on constant replacement dosage of thyroxine", The Journal of Clinical Endocrinology & Metabolism, Vol.54, pp.1118-1124, 1982 DOI: http://dx.doi.org/10.1210/jcem-54-6-1118
  18. Bertoli. A, Fusco. A and Andreoli. A, "Effect of Subclinical Hypothyroidism and Obesity on Whole-Body and Regional Bone Mineral Content", Hormone research, Vol.57, No.3, pp.79-84, 2002 DOI: http://dx.doi.org/10.1159/000057956
  19. Weryha. G, Dassa. Y and Weryha. B, "Bone loss and fracture risk in thyroid diseases", Monographies, Vol.78, No.2, pp.114-118, 2011
  20. Morris. M. S, "The association between serum thyroid-stimulating hormone in its reference range and bone status in postmenopausal American women", Bone, Vol.40 No.4, pp.1128-1134, 2007 DOI: http://dx.doi.org/10.1016/j.bone.2006.12.001
  21. K. W. Oh, E. J. Yun and E. S. Oh, "Relationship between serum thyroid stimulating hormone levels and serum osteoprotegerin levels and bone mineral density in healthy men ", Korean journal of medicine, Vol.66, No.6, pp.609-616, 2004
  22. W. Y. Lee, K. W. Oh and E. J. Rhee, "Relationship between Subclinical Thyroid Dysfunction and Femoral Neck Bone Mineral Density in Women", Archives of medical research, Vol.37 No.4, pp.511-516, 2006 DOI: http://dx.doi.org/10.1016/j.arcmed.2005.09.009
  23. Chobanian. A. V, Bakris. G. L, Black. H. R, Cushman. W. C, Green. L. A, et al., "Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure", Hypertension, Vol.42, No.6, pp.1206-1252, 2003 DOI: http://dx.doi.org/10.1161/01.HYP.0000107251.49515.c2
  24. Genuth. S, Alberti. K. G, Bennett. P, Buse. J, Defronzo. R, Kahn. R, et al., "Follow-up report on the diagnosis of diabetes mellitus," The Expert Committee on the Diagnosis and Classification of Diabetes, a publication of the American Diabetes Association, Vol.22, No.2, pp.71-80, 2004 DOI: http://dx.doi.org/10.2337/diacare.26.11.3160
  25. World Health Organization. "WHO study group on assessment of fracture risk and its application to screening for postmenopausal osteoporosis", Geneva, Switzerland, 1994
  26. Hak. A. E, Pols. H. A, Visser. T. J, Drexhage. H. A, Hofman, et al., "Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women", Annals of Internal Medicine, Vol.132, pp.270-278, 2000
  27. Irwin. K, and Kaie. O, "Thyroid Hormone and the Cardiovascular System", New England Journal of Medicine, Vol.344, No.7, pp.501-509, 2001 DOI: http://dx.doi.org/10.1056/NEJM200102153440707
  28. Joseph. G, Hollowell. N. W, Staehling. W. D, Flanders. W, Harry Hannon. E. W, et al., "Serum TSH, T, and thyroid antibodies in the United States population (1998 to 1994): National Health and Nutrition Examination Survey (NHANES ).III", The Journal of Clinical Endocrinology & Metabolism, Vol.87, No.2, pp.489-499, 2002 https://doi.org/10.1210/jcem.87.2.8182
  29. Baqi. L, Payer. J and Killinger. Z, "Thyrotropin versus thyroid hormone in regulating bone density and turnover in premenopausal women", Endocrine regulations, Vol.44, No.2, pp.57-63, 2010 DOI: http://dx.doi.org/10.4149/endo_2010_02_57
  30. Simonet. W. S, Lacey. D. L, Dunstan. C. R, Kelly. M, Chang. M. S, et al., " Osteoprotegerin; a novel secreted protein involved in the regulation of bone density", Cell, Vol.89, pp.309-319, 1997 DOI: http://dx.doi.org/10.1016/S0092-8674(00)80209-3
  31. H. A. Shin and A. S. Om, "The Correlation between Dietary Intakes of Calcium and Vitamin D and Osteoporosis, Hypertension and Diabetes Mellitus", Korean journal of dairy science and technology, Vol.27, No.2, pp.17-23, 2009
  32. Hollowell. J. G, Staehling. N. W, Flanders. W. D, Hannon. W. H, Gunter. E. W, et al., "Serum TSH, T4, and thyroid antibodies in the United States population (1988-1994): neonatal health and nutrition xamination survey (NHANES III)", Clinical Endocrinology., Vol.87, pp.489-499, 2002 https://doi.org/10.1210/jcem.87.2.8182
  33. Pop. V. J, Kuijpens. J. L, van Baar. A. L, Verkera. G, van Son. M. M, et al., "Low maternal free thyroxine concentrations during early pregnancy are associated with impaired psychomotor development in infancy", Clinical Endocrinology, Vol.50, pp.149-155, 1999 https://doi.org/10.1046/j.1365-2265.1999.00639.x
  34. Y. R. Kim, H. S. Nam and T. Y. Lee, "The Bone Density Level of Korean Men Aged 60 Years and Over, and Its Relevant Factors", Journal of the Korea Academia-Industrial cooperation Society, Vol.14, No.3, pp.1180-1190, 2013 DOI: http://dx.doi.org/10.5762/KAIS.2013.14.3.1180