RÉSUMÉ
Objective:To investigate the correlation between adiponectin gene polymorphism and osteoporosis in patients with differentiated thyroid after thyroid stimulating hormone (thyroid stimulating hormone, TSH) suppression therapy.Methods:A total of 79 patients who underwent resection of thyroid cancer and TSH suppression therapy were collected as research objects. After 5 years of follow-up, the bone mineral density of the patients was measured, and they were divided into normal bone mass group and osteoporosis group. The general data of the two groups of patients were compared, and the distribution frequencies of rs1063539, rs266729, rs3774261, and rs710445 genotypes in the two groups of patients were analyzed. The differences in bone mineral density of patients with different genotypes of rs1063539, rs266729, rs3774261, and rs710445 were analyzed. To explore the risk factors of osteoporosis in patients treated with TSH suppression after differentiated thyroid surgery.Results:General data analysis showed that the family history of osteoporosis ( P=0.021) and preoperative thyroid hormone status ( P=0.022) were significantly different between the two groups (all P<0.05). The genotype frequency deviations of rs1063539, rs266729, rs3774261, and rs710445 conformed to the Hardy-Weinberg equilibrium law. The distribution of the three genotypes of rs1063539 locus was significantly different between the two groups, and the bone mineral density T value of rs1063539 CC+CG genotype (-3.68±0.61) was significantly lower than that of GG type (-3.14±0.47) ( t=3.142, P=0.003). Logistic regression analysis showed that no family history of osteoporosis was a protective factor for osteoporosis in patients with TSH suppression after thyroid cancer surgery ( OR: 0.258, OR 95%CI: 0.082-0.773, P=0.020). Preoperative hyperthyroidism ( OR: 2.203, OR 95%CI: 1.134-4.541, P=0.025) and rs1063539 CC+CG genotype ( OR: 4.392, OR 95%CI: 1.248-17.652, P=0.027) were the risk factors inducing osteoporosis. Conclusion:Adiponectin rs1063539 gene polymorphism is associated with bone mineral density in patients, and rs1063539 CC+CG genotype can increase the risk of osteoporosis in patients treated with TSH suppression after differentiated thyroid surgery.
RÉSUMÉ
Objective:To investigate the correlation between serum recombinant sclerostin (SOST) and dickkopf-related protein 1 (DKK-1) levels and bone metabolism indexes in patients with osteoporosis after differentiated thyroid cancer surgery.Methods:A total of 110 patients diagnosed with osteoporosis after differentiated thyroid cancer surgery were recruited as the study group, and another 110 patients without osteoporosis diagnosed after differentiated thyroid cancer surgery were recruited as the control group. The general data, bone mineral density, serum SOST, DKK-1 levels and bone metabolism indicators N-terminal propeptide of type I procollagen (PINP), bone alkaline phosphatase (BALP), beta-isomerized C-telopeptide (β-CTX), 25-hydroxyvitamin D3 [25- (OH) D3] levels were compared between the two groups. The correlation between serum SOST, DKK-1 levels and bone metabolism indexes was analyzed, and the risk factors affecting the formation of osteoporosis were explored.Results:The T value of bone mineral density in the study group (-3.27±0.92) was significantly lower than that in the control group (-1.23±0.27, t=22.32, P<0.001). The serum SOST (15.84±1.34, t=32.53, P<0.001) and DKK-1 (5.96±1.40, t=4.82, P<0.001) levels in the study group were significantly higher than those in the control group (SOST: 10.24±1.21, DKK-1: 5.05±1.40). The serum PINP (40.95±9.84, t=7.59, P<0.001), BALP (23.14±5.26, t=5.06, P<0.001) and β-CTX (1.07±0.54, t=4.96, P<0.001) in the study group were significantly higher than those in the control group (31.48±8.64, 19.64±4.99, 0.78±0.29), and the 25- (OH) D3 level (13.68±4.49) was significantly lower than that of the control group (18.31±5.72, t=6.68, P<0.001). Serum SOST was positively correlated with PINP ( r=0.33, P=0.001), BALP ( r=0.23, P=0.016) and β-CTX ( r=0.19, P=0.046), but not with 25- (OH) D3 ( r=-0.09, P=0.349). Serum DKK-1 was positively correlated with PINP ( r=0.19, P=0.044), BALP ( r=0.26, P=0.007) and β-CTX ( r=0.21, P=0.028), but not with 25- (OH) D3 ( r=-0.16, P=0.088). Serum SOST and DKK-1 levels were independent risk factors for osteoporosis (all P<0.05) . Conclusion:Serum SOST and DKK-1 levels are independent risk factors for the formation of osteoporosis, which are significantly positively correlated with bone metabolism indexes PINP, BALP, and β-CTX in patients with osteoporosis after differentiated thyroid cancer surgery.