Tzotzas T, Krassas G E, Konstantinidis T, Bougoulia M
Department of Endocrinology and Metabolism, Panagia Hospital, Thessaloniki, Greece.
Thyroid. 2000 Sep;10(9):803-8. doi: 10.1089/thy.2000.10.803.
The aim of this prospective, follow-up study was to examine the influence of overt hypothyroidism (OHP) and subclinical (SHP), before and during thyroxine (T4) treatment, on lipoprotein(a) [Lp(a)], other lipoproteins, and apolipoproteins. Twenty-four patients (17 females, 7 males) with OHP, aged 54 +/- 11.1 years (group A) and 23 patients (females) with SHP aged 50.1 +/- 13.2 years (group B) were evaluated and compared to 34 and 38 controls, respectively. All patients received T4 therapy in a stepwise fashion until euthyroidism was reached. Thyrotropin (TSH), free thyroxine (FT4), and total triiodothyronine (TT3) levels were measured before T4 therapy and repeatedly every 4 weeks after the initiation of treatment until the euthyroid state was reached. Levels of Lp(a), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDLc), high-density lipoprotein cholesterol (HDLc), apolipoprotein A1 (apoA1) and apolipoprotein B (apoB) were measured before and 4 months after the achievement of euthyroidism. Additionally, body mass index (BMI) was also evaluated. We found that in OHP patients, levels of TC, LDLc, and apoB were elevated before treatment and decreased significantly after the return to the euthyroid state. BMI and levels of triglycerides also decreased significantly; Lp(a) was higher in OHP patients in comparison with controls and decreased significantly by 14.56% (25.29% in men and 10.34% in women) during T4 treatment. In SHP patients, levels of all common lipoproteins, apolipoproteins, and Lp(a) did not differ significantly from controls before treatment and did not change after the euthyroid stage was reached. It is concluded that in overt hypothyroidism, Lp(a) levels and most of the lipoproteins were elevated before treatment and decreased significantly. In subclinical hypothyroidism, lipoproteins and Lp(a) levels were normal at baseline and did not change during treatment.
这项前瞻性随访研究的目的是，在甲状腺素（T4）治疗前及治疗期间，研究显性甲状腺功能减退（OHP）和亚临床甲状腺功能减退（SHP）对脂蛋白(a) [Lp(a)]、其他脂蛋白及载脂蛋白的影响。24例年龄为54±11.1岁的OHP患者（17例女性，7例男性）（A组）和23例年龄为50.1±13.2岁的SHP女性患者（B组）接受了评估，并分别与34例和38例对照者进行比较。所有患者均逐步接受T4治疗，直至达到甲状腺功能正常状态。在T4治疗前测量促甲状腺激素（TSH）、游离甲状腺素（FT4）和总三碘甲状腺原氨酸（TT3）水平，并在开始治疗后每4周重复测量一次，直至达到甲状腺功能正常状态。在达到甲状腺功能正常状态前及达到后4个月测量Lp(a)、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDLc）、高密度脂蛋白胆固醇（HDLc）、载脂蛋白A1（apoA1）和载脂蛋白B（apoB）的水平。此外，还评估了体重指数（BMI）。我们发现，OHP患者在治疗前TC、LDLc和apoB水平升高，恢复到甲状腺功能正常状态后显著降低。BMI和甘油三酯水平也显著降低；OHP患者的Lp(a)高于对照者，在T4治疗期间显著降低了14.56%（男性降低25.29%，女性降低10.34%）。在SHP患者中，所有常见脂蛋白、载脂蛋白和Lp(a)的水平在治疗前与对照者无显著差异，达到甲状腺功能正常阶段后也未发生变化。结论是，在显性甲状腺功能减退中，Lp(a)水平和大多数脂蛋白在治疗前升高，且显著降低。在亚临床甲状腺功能减退中，脂蛋白和Lp(a)水平在基线时正常，治疗期间未发生变化。
