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| 老年骨质疏松女性甲状腺激素敏感性与维生素D降低的相关性研究 |
| Correlation between thyroid hormones sensitivity and decreased vitamin D in elderly women with osteoporosis |
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| DOI：10.3969/j.issn.1006-7108.2026.03.009 |
| 中文关键词: 甲状腺激素敏感性 老年女性 骨质疏松 维生素D |
| 英文关键词:sensitivity to thyroid hormones elderly women osteoporosis vitamin D |
| 基金项目:四川省中医药管理局课题（2024MS068，25MSZX082） |
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| 中文摘要: |
| 目的 探讨老年骨质疏松（OP）女性维生素D水平降低与甲状腺激素的敏感性受损风险之间的相关性。方法 研究纳入了2021年1月至2024年8月入院的60岁以上甲状腺功能正常的老年OP女性患者共894例。257例25-羟基维生素D[25-(OH)D]≥30 ng/mL为正常组，637例<30 ng/mL为降低组。二元Logistic回归分析血清维生素D降低与甲状腺激素敏感性指标之间的关系。包括促甲状腺激素指数（TSHI）、游离三碘甲状腺原氨酸/游离甲状腺素（FT3/FT4）、甲状腺反馈分位数指数（TFQI）和甲状腺素抵抗指数（TT4RI）。使用限制性立方样条分析（RCS）进行线性检验以评估25-(OH)D水平与甲状腺激素敏感性受损风险间可能的非线性关系。结果 25-(OH)D水平与TFQI呈负相关，与FT3/FT4比值呈正相关，相关系数为?0.10，0.11，P<0.05。25-(OH)D降低与甲状腺激素敏感性受损的风险有关，高TFQI与低FT3/FT4比值的OR分别为：1.48（95 %CI：1.08~2.05；P=0.02）、1.51（95 %CI：1.04~2.19；P=0.03）。当25-(OH)D≥43.08 ng/mL或≤24.53 ng/mL时，高TFQI风险显著增加，二者呈U型关系，当25-(OH)D≤24.53 ng/mL时，低FT3/FT4比值风险明显增加，二者存在非线性关系。结论 老年OP女性维生素D降低与甲状腺激素敏感性受损风险增加相关，维持适宜范围的维生素D可能会有效改善甲状腺激素敏感性。 |
| 英文摘要: |
| Objective To investigate the relationship between vitamin D level and thyroid hormone sensitivity in elderly women with osteoporosis (OP). Methods A total of 894 elderly OP inpatients women over 60 years old with normal thyroid function were included in the study from January 2021 to August 2024. There were 257 patients with 25-(OH)D ≥ 30 ng/mL as normal group and 637 patients with 25-(OH)D < 30 ng/mL as decreased group. Binary logistic regression was used to analyze the relationship between decreased serum vitamin D and thyroid hormone sensitivity indicators. Thyroid stimulating hormone index (TSHI), free triiodothyronine/free thyroxine (FT3/FT4), thyroid feedback quantile-based index (TFQI), and thyroxine resistance index (TT4RI) were included. Linear tests were performed using restricted cubic spline analysis (RCS) to assess the possible nonlinear relationship between 25-(OH)D levels and the risk of impaired sensitivity to thyroid hormones. Results The level of 25-(OH)D was negatively correlated with TFQI and positively correlated with FT3/FT4 ratio (r = ?0.10, 0.11, P<0.05). Decreased 25-(OH)D was associated with the risk of impaired sensitivity to thyroid hormones, and the OR of high TFQI and low FT3/FT4 ratio were 1.48 (95% CI: 1.08-2.05; P=0.02), 1.51 (95% CI: 1.04-2.19; P=0.03), respectively. When 25-(OH)D was ≥43.08 ng/mLor ≤24.53 ng/mL, the risk of high TFQI increased significantly. When 25-(OH)D was ≤24.53 ng/mL, the risk of low FT3/FT4 ratio increased significantly, and there was a nonlinear relationship between them. Conclusion Decreased vitamin D is associated with an increased risk of impaired thyroid hormone sensitivity in elderly women with OP. Maintaining an appropriate range of vitamin D may effectively improve sensitivity to thyroid hormones. |
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