Smorawińska Alicja, Korman Eugeniusz, Rajewski Andrzej, Karlik Alicja
Kliniki Endokrynologii i Diabetologii Wieku Rozwojowego AM w Poznaniu.
Psychiatr Pol. 2003 Jan-Feb;37(1):39-46.
There are clinical similarities between anorexia nervosa (AN) and hypothyroidism. Previous reports have shown decrease FT3, increase rT3, sporadically decrease FT4 and normal levels of serum TSH.
To assess thyroid function in 36 patients with AN (4 males, 32 females the subjects ages ranged from 12 to 18 yrs) serum levels of FT4, FT3, rT3, TSH were measured. Out of this group, 24 patients have been singled out to examine the lipid metabolism by measuring the level of cholesterol, HDL, LDL, triglycerides.
67% (24) of the examined group resulted in low level of FT4 (0.75-0.97 ng/dcl), but decrease FT3 (= 0.67 pg/ml) was only found with 1 patient. The level of rT3 (measured in 94% (34) patients) were normal. The level of TSH were low (0.87-0.97 muIU/ml) in 25% (9) of patients, but 6 of them also manifested decrease FT4 (0.87-0.97 ng/dcl). At the same time, we found higher level of cholesterol in 63% of patients, decrease HDL in 71%. It is interesting to notice that in 80% of cases with a lipid metabolism disorder we found decrease FT4.
Thyroid dysfunctions may be one of the essential reasons for lipid metabolism disorder in AN.
神经性厌食症（AN）与甲状腺功能减退在临床上存在相似之处。既往报道显示，游离三碘甲状腺原氨酸（FT3）降低、反三碘甲状腺原氨酸（rT3）升高，偶见游离甲状腺素（FT4）降低，血清促甲状腺激素（TSH）水平正常。
为评估36例AN患者（4例男性，32例女性，年龄12至18岁）的甲状腺功能，检测了血清FT4、FT3、rT3、TSH水平。从该组患者中挑选出24例，通过检测胆固醇、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、甘油三酯水平来检查脂质代谢情况。
受检组中67%（24例）的患者FT4水平较低（0.75 - 0.97 ng/dcl），但仅1例患者出现FT3降低（= 0.67 pg/ml）。94%（34例）患者的rT3水平正常。25%（9例）患者的TSH水平较低（0.87 - 0.97 μIU/ml），但其中6例同时伴有FT4降低（0.87 - 0.97 ng/dcl）。同时，我们发现63%的患者胆固醇水平较高，71%的患者HDL降低。有趣的是，在80%脂质代谢紊乱的病例中我们发现了FT4降低。
甲状腺功能障碍可能是AN患者脂质代谢紊乱的重要原因之一。
