THYROID FUNCTION AND OSTEOPOROSIS

骨质疏松症是一种老年妇女的毁容疾病， 严重丧失独立性，发病率和死亡率很高。 过多的甲状腺激素，无论是内源性的还是外源性的， 与骨量减少和骨折风险增加有关。 然而，这些关联的程度和临床意义是 未知和研究检查骨折风险使用的客观措施， 甲状腺功能没有做过。 甲状腺功能障碍可能会改变 通过骨量减少以外的机制发生骨折的风险，例如 神经肌肉功能改变或骨结构异常。 我们建议对甲状腺功能的关联进行全面研究， 通过血清促甲状腺激素、骨折、骨量和骨丢失进行评估。 我们将 使用已经从NIH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， 的危险因素。 1986年，9 704人 在美国的四个国家， 城市 在基线时收集了关于多个变量的大量数据， 包括甲状腺功能亢进和甲状腺激素的历史信息 使用，并将血清样品在-190 ℃下存档。 我们将使用 有效的巢式病例队列设计：450名骨折妇女 (150脊椎骨折），因为最初的检查将进行比较， 从队列中随机抽取450名妇女。 我们将测量超- 敏感的第三代血清TSH水平的血清，收集自 受试者基线。 我们计划测试低TSH水平， 表明甲状腺激素水平异常高， 骨质疏松性骨折，骨量减少，骨丢失增加， 神经肌肉功能 我们还将研究促甲状腺激素（TSH） 和一种新开发的技术，可以评估骨质量，定量 超声（QUS）。 这项拟议的研究将是第一项大型前瞻性研究， 甲状腺功能对骨质、骨丢失和骨折的影响 同一组人 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。 的结果 这项研究将有助于确定与甲状腺功能亢进相关的风险。 激素，并有助于我们了解所涉及的机制。

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.