老年人群TPOAb、TGAb及TSH与骨代谢的相关性研究

目的：探讨甲功正常的老年人群中，甲状腺过氧化物酶抗体（TPOAb），甲状腺球蛋白抗体（TGAb）、促甲状腺激素（TSH）与骨代谢的相关性。方法：回顾性地选取2018-2020年期间在我院住院，甲功正常的老年患者205例为研究对象，根据骨密度检查结果分为骨量正常组（62例），骨量异常组（143例），比较两组间TPOAb阳性率及TGAb阳性率、TSH水平的差异。根据TSH水平分为正常范围低TSH组和正常范围高TSH组，比较两组间骨量异常的发生率差异，采用logistic回归分析正常范围低水平TSH、TPOAb阳性、TGAb阳性与骨量异常的相关性。结果：1.骨量异常组，TPOAb阳性率明显高于骨量正常组，TGAb阳性率无显著差异， TSH水平明显低于骨量正常组；2.正常范围低TSH组骨量异常发生率明显高于正常范围高TSH组。3.logistic回归分析结果提示正常范围低TSH水平、TPOAb阳性是骨量异常的独立危险因素。结论:正常范围低TSH水平、TPOAb可能影响老年人骨代谢，TGAb对骨代谢影响不大。

The Correlation Study Between TPOAb, TGAb, TSH and Bone Metabolism in the Elderly

Abstract: Objective: To investigate the correlation between thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TGAb), thyroid stimulating hormone (TSH) and bone metabolism in elderly people. Methods: 205 elderly patients with normal thyroid function in our hospital from 2018 to 2020 were selected as the research objects. According to the results of bone mineral density examination, they were divided into normal bone mass group (62 cases) and abnormal bone mass group (143 cases). The positive rates of TPOAb, TGAb and TSH were compared between the two groups. According to the level of TSH, they were divided into normal range low TSH group and normal TSH group. The incidence of abnormal bone mass between the two groups was compared. The correlation between normal range low TSH, TPOAb positive, TGAb positive and abnormal bone mass was analyzed by logistic regression. Results: 1. The positive rate of TPOAb in abnormal bone mass group was significantly higher than that in normal bone mass group, the positive rate of TGAb had no significant difference, and the level of TSH was significantly lower than that in normal bone mass group; 2. The incidence of abnormal bone mass in normal range low TSH group was significantly higher than that in normal TSH group. 3. Logistic regression analysis showed that low TSH level in normal range and positive TPOAb were independent risk factors for abnormal bone mass. Conclusion: low TSH level and TPOAb in normal range may affect bone metabolism in the elderly, while TGAb has little effect on bone metabolism.