甲状腺及交感神经对甲状腺功能减退和甲状腺功能亢进患者血浆瘦素的影响。
Thyroid and sympathetic influences on plasma leptin in hypothyroidism and hyperthyroidism.
作者信息
Pinkney J H, Goodrick S J, Katz J R, Johnson A B, Lightman S L, Coppack S W, Medbak S, Mohamed-Ali V
机构信息
Department of Medicine, University of Bristol, Bristol Royal Infirmary, UK.
出版信息
Int J Obes Relat Metab Disord. 2000 Jun;24 Suppl 2:S165-6. doi: 10.1038/sj.ijo.0801316.
OBJECTIVES
To determine the dependence of plasma leptin concentrations upon circulating noradrenaline (NA) and thyroid hormones (TH) in humans.
DESIGN
Cross-sectional study in 40 newly diagnosed untreated patients with primary thyroid disease, and 69 lean and obese euthyroid control subjects.
MEASUREMENTS
Plasma leptin, NA, free T3 (fT3) and TSH in the fasting state. Anthropometry and % body fat (electrical bioimpedance).
RESULTS
Leptin levels were highest in 37 obese euthyroid and 22 hypothyroid (median [interquartiles]31.5 [19.0- 48.0], 19.2 [11.5-31.5] ng ml(-1)), and lowest in 32 lean euthyroid and 18 hyperthyroid subjects (6.6 [3.9-14.4], 8.9 [5.5-11.1]; ANOVA, P< 0.0001). Plasma NA was similar in all groups (P= n.s.). In obese controls, TSH correlated with % body fat and leptin (r= 0.67, r= 0.61; P< 0.001). Treatment of hypothyroidism (n= 10) with T4 reduced leptin from 20.8 [11.8-31.6] to 12.9[4.6-21.2] (P= 0.005) with no change in BMI.
CONCLUSIONS
Thyroid status modifies leptin secretion independently of adiposity and NA. The data suggest leptin-thyroid interactions at hypothalamic and adipocyte level.
目的
确定人体血浆瘦素浓度与循环去甲肾上腺素（NA）和甲状腺激素（TH）之间的相关性。
设计
对40例新诊断的未经治疗的原发性甲状腺疾病患者以及69例体重正常和肥胖的甲状腺功能正常的对照者进行横断面研究。
测量
空腹状态下的血浆瘦素、NA、游离T3（fT3）和促甲状腺激素（TSH）。人体测量学指标及体脂百分比（生物电阻抗法）。
结果
37例肥胖且甲状腺功能正常者和22例甲状腺功能减退者的瘦素水平最高（中位数[四分位间距]31.5 [19.0 - 48.0]，19.2 [11.5 - 31.5] ng/ml），32例体重正常且甲状腺功能正常者和18例甲状腺功能亢进者的瘦素水平最低（6.6 [3.9 - 14.4]，8.9 [5.5 - 11.1]；方差分析，P < 0.0001）。所有组的血浆NA水平相似（P = 无显著差异）。在肥胖对照组中，TSH与体脂百分比和瘦素相关（r = 0.67，r = 0.61；P < 0.001）。10例甲状腺功能减退患者接受T4治疗后，瘦素水平从20.8 [11.8 - 31.6]降至12.9[4.6 - 21.2]（P = 0.005），体重指数（BMI）无变化。
结论
甲状腺状态独立于肥胖和NA改变瘦素分泌。数据提示在下丘脑和脂肪细胞水平存在瘦素 - 甲状腺相互作用。
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