THYROID FUNCTION AND OSTEOPOROSIS

骨质疏松症是一种老年女性的毁容疾病，它会导致 严重丧失独立性和严重的发病率和死亡率。 过量的甲状腺激素，无论是内源性的还是外源性的，都可能是 与骨量减少和骨折风险增加有关。 然而，这些关联的大小和临床意义是 未知和研究使用客观的测量方法检查骨折风险 甲状腺功能还没有完成。甲状腺功能障碍可能会改变 通过减少骨量以外的机制发生骨折的风险，例如 神经肌肉功能改变或骨骼结构异常。 我们建议对甲状腺功能的相关性进行全面的研究，因为 通过血清促甲状腺激素、骨折、骨量和骨丢失进行评估。我们会 使用已经从美国国立卫生研究院赞助的骨质疏松症研究中收集的数据 骨折(SOF)，最大和最全面的前瞻性研究 骨质疏松性骨折的危险因素尚未进行研究。1986年，9704人 女性从四个美国的基于人口的名单中招募到SOF 城市。在基线上收集了关于多个变量的大量数据， 包括有关甲状腺机能亢进症和甲状腺激素的历史信息 使用，血清样本在零下190摄氏度存档。我们将使用 高效嵌套病例队列设计：450例女性骨折患者 (150个脊椎骨折)，因为最初的检查将与 从队列中随机抽取450名女性。我们将测量超 中国人血清中敏感的第三代血清TSH水平 受试者在基线位置。我们计划测试以下假设：低促甲状腺激素水平， 表明甲状腺激素水平异常高，与 骨质疏松性骨折，骨量减少，骨丢失增加，并改变 神经肌肉功能。我们还将研究促甲状腺激素与 以及一种新开发的技术，可以定量地评估骨骼质量 超声(QUS)。 这项拟议的研究将是第一个大型前瞻性研究，以检查 甲状腺功能对老年人骨量、骨丢失和骨折的影响 同一批人。拟议研究的费用相对较小，因为它 使用已经收集的数据和样本。结果是 这项研究将有助于确定与甲状腺过度相关的风险。 荷尔蒙，并有助于我们理解所涉及的机制。

Osteoporosis is a disfiguring disease of older women that causes significant loss of independence and substantial morbidity and mortality. Excessive thyroid hormone, either endogenous or exogenous, may be associated with reduced bone mass and an increased risk of fracture. However, the magnitude and clinical significance of these associations are unknown and studies examining fracture risk using an objective measure of thyroid function have not been done. Thyroid dysfunction may alter the risk of fractures through mechanisms other than reduced bone mass, such as altered neuromuscular function or abnormal bone architecture. We propose a comprehensive study of the association of thyroid function, as assessed by serum TSH, and fractures, bone mass, and bone loss. We will use data already collected from the NIH-sponsored Study of Osteoporotic Fractures (SOF), the largest and most comprehensive prospective study of risk factors for osteoporotic fractures yet performed. In 1986, 9, 704 women were recruited for SOF from population-based listings in four US cities. Extensive data on multiple variables were collected at baseline, including historical information on hyperthyroidism and thyroid hormone use, and a serum sample was archived at -190 degree C. We will use an efficient nested case-cohort design: 450 women who have suffered fractures (150 vertebral fractures) since the initial exam will be compared to a random sample of 450 women from the cohort. We will measure ultra- sensitive third generation serum TSH levels on sera that was collected from subjects at baseline. We plan to test the hypotheses that low TSH levels, indicating abnormally high thyroid hormone levels, are associated with osteoporotic fractures, reduced bone mass, increased bone loss, and altered neuromuscular function. We will also examine the relationship between TSH and a newly developed technique which may assess bone quality, quantitative ultrasound (QUS). The proposed study will be the first large prospective study to examine the effects of thyroid function on bone mass, bone loss, and fractures in the same cohort. The cost of the proposed study is relatively small since it uses data and samples that have already been collected. The results of this study will help define the risks associated with excessive thyroid hormone, and contribute to our understanding of the mechanisms involved.