To investigate relationships between serum chemerin and bone mineral density (BMD) in patients with newly diagnosed Graves disease (GD). Methods: A total of 120 newly diagnosed GD patients with a course more than 3 months were enrolled from the Department of Endocrinology between June 2013 and June 2015. Sixty age- and sex-matched healthy people served as a normal control. Serum levels of chemerin, β-crosslaps (β-CTX), and N-MID-osteocalcin (N-MID-OT) were measured by ELISA. Fat mass and BMD were evaluated by dual energy X-ray absorptiometry (DEXA). Results: Compared with the normal control, the fat mass, lean weight, fat mass index (FMI) and body mass index (BMI) in the GD group were decreased, and BMD in all skeletal sites was decreased. There was a positive correlation between them (all P<0.05). Serum level of chemerin was increased and it was positively correlated with β-CTX or N-MID-OT level and negatively correlated with fat mass, FMI or BMI in the GD group. There was a negative correlation between chemerin level and BMD in femoral neck, total hip, lumbar or right forearm distal 1/3 (rs=-0.352, -0.279, -0.379, -0.289, -0.394; P<0.05). After adjusting for age, fat mass or BMI, the correlation of chemerin with total hip or bone mineral density remained significant (rs=-0.273, -0.378; P<0.05). Multiple linear regression analysis revealed that chemerin or BMI was correlated with BMD (P<0.05). Conclusion: The decrease of bone mineral density in patients with GD is not only related to the direct or indirect effect of excessive thyroid hormones on systemic and osteoblastic cells, but it is also related to the negative regulation of bone metabolism due to the elevated chemerin level.
目的：观察初治甲状腺功能亢进症(甲亢)Graves病(Graves disease，GD)患者脂肪细胞因子趋化素(chemerin)水平的变化，探讨其与骨密度降低的关系。方法：随机收集内分泌科门诊确诊的120例病程>3个月的初治甲亢GD患者为GD组，收集同期同院健康体检中心年龄、性别相匹配的健康体检者60人为正常对照组，两组均进行chemerin，骨转换标志物1型胶原羧基端β特殊序列(β-crosslaps，β-CTX)和N端中分子骨钙素(N-MID-osteocalcin，N-MID-OT)检测以及脂肪量、骨密度测量；chemerin，β-CTX及N-MID-OT均采用ELISA法测定；脂肪量、骨密度检查采用双能X线骨密度仪法。结果：GD组患者较正常对照组脂肪量、瘦体重、脂肪量指数(fat mass index，FMI)、体重指数(BMI) 下降，各部位骨密度降低，这些因素间呈正相关(均P<0.05)。GD组chemerin水平升高，与β-CTX和N-MID-OT呈正相关(rs分别为0.456和0.541，均P<0.05)，与脂肪量、FMI和BMI呈负相关(rs分别为–0.285，–0.281，–0.275，均P<0.05)。 GD组chemerin水平与股骨颈、全髋关节、腰椎、右前臂远端1/3处及全身骨密度呈负相关(rs分别为–0.352，–0.279，–0.344，–0.289及–0.394，均P<0.05)，校正年龄、脂肪量、BMI后，chemerin与全髋关节、全身骨密度的相关性依然存在(rs分别为–0.273和–0.378，均P<0.05)；多元线性回归分析示chemerin和BMI可作为全身骨密度的独立预测因子。结论：GD患者骨密度的降低除了与过量甲状腺激素对全身和骨细胞直接和间接作用导致骨吸收增强有关外，可能还与chemerin水平增高对骨代谢的负性调控作用有关。.