格雷夫斯病和甲状腺功能减退症患者的血清瘦素水平及身体成分的生物电阻抗评估

Serum leptin levels and bioelectrical impedance assessment of body composition in patients with Graves' disease and hypothyroidism.

作者信息

Miyakawa M, Tsushima T, Murakami H, Isozaki O, Takano K

机构信息

Department of Internal Medicine, Institute of Clinical Endocrinology, Tokyo Women's Medical University, Japan.

出版信息

Endocr J. 1999 Oct;46(5):665-73. doi: 10.1507/endocrj.46.665.

DOI:10.1507/endocrj.46.665

PMID:10670752

Abstract

We investigated whether thyroid status modulates serum leptin concentrations and body composition as determined by bioelectric impedance analysis (BIA). The percent body fat mass (%FM) in male Graves' disease was significantly lower than that in age- and sex- matched normal subjects, at the levels of 11.4+/-6.4% (mean+/-SD) vs 19.9+/-9.2% for men (n=12, P<0.05) but not for women (22.6+/-7.6% vs 24.9+/-13.1%, n=28). In contrast, in female hypothyroidism (n=11) %FM was significantly higher than that in normal subjects (32.9+/-11.5%, P<0.01). Among other body composition parameters, the percentage of body water (%BW), and lean body mass (LBM) were significantly lower in hypothyroid patients, and the ECM (extracellular mass)/BCM (body cell mass) ratio was significantly (P<0.0001) increased in Graves' disease which was the result of marked depletion of BCM with concomitant expansion of ECM. The serum leptin levels were significantly decreased in male Graves' patients (2.3+/-0.7 ng/ml, P<0.05), whereas in female Graves' patients (8.8+/-5.9 ng/ml) and patients with hypothyroidism (9.5+/-7.6 ng/ml), the levels were not different from those of normal controls matched for BMI or %FM. There was a positive correlation between serum leptin levels and %FM in female Graves' patients (r=0.635, P=0.001) and in hypothyroid patients (r=0.801, P=0.014) but not in male Graves patients. There was no significant relationship between serum leptin levels and thyroid hormones, TRAb, or TSAb. In euthyroid obese subjects there was a positive relationship between serum leptin levels and serum TSH levels (r=0.37, P<0.01). These results suggest that hyperthyroidism is characterized by the decreased fat mass and serum leptin levels in men, but female patients appear to be resistant to the effect of thyroid hormones. Together with previous reports, thyroid status has a minor role in the regulation of serum leptin levels.

摘要

我们研究了甲状腺状态是否会调节血清瘦素浓度以及通过生物电阻抗分析（BIA）测定的身体成分。男性格雷夫斯病患者的体脂百分比（%FM）显著低于年龄和性别匹配的正常受试者，男性患者分别为11.4±6.4%（平均值±标准差）和19.9±9.2%（n = 12，P<0.05），而女性患者则无差异（分别为22.6±7.6%和24.9±13.1%，n = 28）。相反，女性甲状腺功能减退患者（n = 11）的%FM显著高于正常受试者（32.9±11.5%，P<0.01）。在其他身体成分参数中，甲状腺功能减退患者的身体水分百分比（%BW）和瘦体重（LBM）显著降低，而格雷夫斯病患者的细胞外质量（ECM）/身体细胞质量（BCM）比值显著升高（P<0.0001），这是由于BCM显著减少并伴有ECM扩张所致。男性格雷夫斯病患者的血清瘦素水平显著降低（2.3±0.7 ng/ml，P<0.05），而女性格雷夫斯病患者（8.8±5.9 ng/ml）和甲状腺功能减退患者（9.5±7.6 ng/ml）的血清瘦素水平与根据BMI或%FM匹配的正常对照组无差异。女性格雷夫斯病患者（r = 0.635，P = 0.001）和甲状腺功能减退患者（r = 0.801，P = 0.014）的血清瘦素水平与%FM呈正相关，而男性格雷夫斯病患者则无此相关性。血清瘦素水平与甲状腺激素、促甲状腺素受体抗体（TRAb）或促甲状腺素刺激抗体（TSAb）之间无显著关系。在甲状腺功能正常的肥胖受试者中，血清瘦素水平与血清促甲状腺激素（TSH）水平呈正相关（r = 0.37，P<0.01）。这些结果表明，甲状腺功能亢进在男性中表现为脂肪量和血清瘦素水平降低，但女性患者似乎对甲状腺激素的作用具有抵抗性。与先前的报道一致，甲状腺状态在血清瘦素水平的调节中作用较小。