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严重甲状腺功能减退患者的类固醇、性激素结合球蛋白、同型半胱氨酸、特定激素以及脂质和碳水化合物代谢标志物及其甲状腺激素补充后的变化。

Steroids, sex hormone-binding globulin, homocysteine, selected hormones and markers of lipid and carbohydrate metabolism in patients with severe hypothyroidism and their changes following thyroid hormone supplementation.

作者信息

Bicíková Marie, Hampl Richard, Hill Martin, Stanická Soia, Tallová Jaroslava, Vondra Karel

机构信息

Institute of Endocrinology, Praha, Czech Republic.

出版信息

Clin Chem Lab Med. 2003 Mar;41(3):284-92. doi: 10.1515/CCLM.2003.045.

DOI:10.1515/CCLM.2003.045
PMID:12705335
Abstract

Laboratory markers of thyroid function, selected steroid hormones, sex hormone-binding globulin (SHBG), homocysteine, prolactin, major markers of lipid- and glucose metabolism and of insular-growth hormone axes were investigated in fasting sera from 16 female patients with severe hypothyroidism after thyroidectomy because of thyroid cancer. The results obtained in severe hypothyroidism within 5-6 weeks after withdrawal of thyroid substitution therapy before control scintigraphy were compared with those obtained after correction of thyroid function. Elevated levels of homocysteine and prolactin in hypothyroidism significantly decreased after correction, while SHBG concentration increased. Correction of thyroid function led to significant changes of growth hormone and immunoglobulin F1 (decrease and increase, respectively), while insulin and proinsulin increased only insignificantly. Elevated levels of total cholesterol and triglycerides in hypothyroidism were normalized, along with a significant increase in high density lipoprotein (HDL)-cholesterol. As revealed by correlation and factor analyses, different relationships characterizing both states were found in hypothyroidism and after correction of thyroid function. A strong inverse relationship between homocysteine and free thyroid hormones confirms the effect of thyroid hormones on homocysteine metabolism. No such inverse relation was found in euthyroid state, however. Similarly, in hypothyroidism only, dehydroepiandrosterone sulfate correlated positively with immunoglobulin F1 and homocysteine and negatively with thyroid hormones and SHBG.

摘要

对16例因甲状腺癌行甲状腺切除术后出现严重甲状腺功能减退的女性患者的空腹血清进行了检测,分析了甲状腺功能的实验室指标、特定类固醇激素、性激素结合球蛋白(SHBG)、同型半胱氨酸、催乳素、脂质和葡萄糖代谢以及岛状生长激素轴的主要指标。将在对照闪烁扫描前停用甲状腺替代治疗后5 - 6周内严重甲状腺功能减退时获得的结果与甲状腺功能纠正后获得的结果进行比较。甲状腺功能减退时升高的同型半胱氨酸和催乳素水平在纠正后显著降低,而SHBG浓度升高。甲状腺功能的纠正导致生长激素和免疫球蛋白F1发生显著变化(分别降低和升高),而胰岛素和胰岛素原仅略有增加。甲状腺功能减退时升高的总胆固醇和甘油三酯水平恢复正常,同时高密度脂蛋白(HDL)胆固醇显著增加。通过相关性和因子分析发现,甲状腺功能减退状态和甲状腺功能纠正后存在不同的关系特征。同型半胱氨酸与游离甲状腺激素之间存在强烈的负相关,证实了甲状腺激素对同型半胱氨酸代谢的影响。然而,在甲状腺功能正常状态下未发现这种负相关。同样,仅在甲状腺功能减退时,硫酸脱氢表雄酮与免疫球蛋白F1和同型半胱氨酸呈正相关,与甲状腺激素和SHBG呈负相关。

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