A prospective study of thyroid function, bone loss, and fractures in older men: The MrOS study.
A prospective study of thyroid function, bone loss, and fractures in older men: The MrOS study.
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对甲状腺功能，骨质流失和骨折的前瞻性研究：MROS研究。
DOI：
10.1002/jbmr.1774
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发表时间：
2013-03
影响因子：
6.2
通讯作者：
Bauer, Douglas C.
中科院分区：
文献类型：
--
作者：
Waring, Avantika C.;Harrison, Stephanie;Fink, Howard A.;Samuels, Mary H.;Cawthon, Peggy M.;Zmuda, Joseph M.;Orwoll, Eric S.;Bauer, Douglas C.
过量的甲状腺激素与老年女性骨质流失和骨折风险增加有关，但在男性中几乎没有数据。我们试图确定甲状腺功能是否与老年男性骨质流失和骨折风险独立相关。数据分析来自男性骨质疏松性骨折（MrOS）研究，该研究是一项年龄在65岁及以上的社区居住美国男性队列研究。采用病例队列设计，对397例确诊为非脊柱骨折（包括157例髋部骨折）的男性和1420例随机选择的无骨折男性在-80 ℃下储存的空腹基线血清进行促甲状腺激素（TSH）和游离甲状腺素（FT 4）测定。TSH和FT 4作为连续变量和甲状腺功能类别（亚临床甲状腺功能亢进、甲状腺功能正常和亚临床甲状腺功能减退）进行分析。在基线和平均随访4.6年后测量髋关节DXA（Hologic QDR 4500）。集中裁定非脊柱骨折事件。采用多变量回归方法评估骨丢失，并采用风险模型评估骨折风险，该模型考虑了病例队列抽样，调整了年龄、临床部位、BMI、种族、体力活动、皮质类固醇使用、吸烟、饮酒和甲状腺药物使用。在完全校正的分析中，TSH与非脊柱骨折的风险无关（TSH每SD降低RH 0.92，95% CI 0.74 - 1.14），但与髋部骨折的风险显著相关（RH 1.31 [1.01 - 1.71]），该风险在正常范围TSH值（RH 1.21 [1.00 - 1.47]）中持续存在。TSH或FT 4与骨丢失之间没有关联，甲状腺功能类别的骨折风险没有显著差异。我们的结论是，虽然TSH和FT 4都与骨质流失无关，但血清TSH降低可能与老年男性髋部骨折风险增加有关。
Excess thyroid hormone is associated with increased bone loss and fracture risk in older women, but few data exist in men. We sought to determine if thyroid function is independently associated with bone loss and fracture risk in older men. Data were analyzed from the Osteoporotic Fractures in Men (MrOS) Study, a cohort of community-dwelling US men aged 65 years and older. Using a case-cohort design, fasting baseline serum archived at −80C was assayed for thyrotropin (TSH) and free thyroxine (FT4) in 397 men with confirmed non-spine fracture, including 157 hip fractures, and 1420 randomly selected men without fracture. TSH and FT4 were analyzed as continuous variables and as thyroid function categories (subclinical hyperthyroid, euthyroid, and subclinical hypothyroid). Hip DXA (Hologic QDR4500) was measured at baseline and after a mean follow-up of 4.6 yr. Incident nonspine fractures were centrally adjudicated. Bone loss was evaluated with multivariate regression methods and fractures risk was evaluated using hazard models that accounted for the case-cohort sampling, adjusted for age, clinic-site, BMI, race, physical activity, corticosteroid use, smoking, alcohol intake, and thyroid medication use. In fully adjusted analyses, TSH was not associated with risk of nonspine fracture (RH 0.92 per SD decrease in TSH, 95% CI 0.74 – 1.14), but was significantly associated with risk of hip fracture (RH 1.31 [1.01 – 1.71]) which persisted among normal range TSH values (RH 1.21 [1.00 – 1.47]). There was no association between TSH or FT4 and bone loss, and fracture risk did not differ significantly by thyroid function category. We conclude that while neither TSH nor FT4 are associated with bone loss, lower serum TSH may be associated with an increased risk of hip fractures in older men.
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影响因子：
6.3
作者：
Berry SD;Ngo L;Samelson EJ;Kiel DP
通讯作者：
Kiel DP
影响因子：
39.2
作者：
Bauer, DC;Ettinger, B;Stone, KL
通讯作者：
Stone, KL
影响因子：
4.5
作者：
Bensenor, Isabela M.;Lotufo, Paulo A.;Scazufca, Marcia
通讯作者：
Scazufca, Marcia
影响因子：
2.2
作者：
Orwoll, E;Blank, JB;Stone, K
通讯作者：
Stone, K
影响因子：
2.7
作者：
El Hadidy el HM;Ghonaim M;El Gawad SSh;El Atta MA
通讯作者：
El Atta MA