Langer P, Kocan A, Tajtakova M, Petrik J, Koska J, Hucková M, Hanzen E, Ksinantova L, Radikova Z, Imrich R, Trnovec T, Blazicek P, Sebokova E, Klimes I
Institute of Experimental Endocrinology, Slovak Academy of Sciences, 833 06 Bratislava, Slovakia.
Endocr Regul. 2003 Sep;37(3):175-80.
To compare the levels of serum cholesterol with thyroid function as estimated by the level of thyrotropin and free thyroxine with possible participation of thyroperoxidase antibodies in large number of adults examined within large field surveys focused on the evaluation of thyroid status of Slovak rural population.
Serum level of cholesterol and thyrotropin (TSH) was estimated in a total of 2786 adults. In addition, in 2038 of them also the level of free thyroxine (FT4), total triiodothyronine (TT3), cholesterol, triglycerides and phospholipids was measured. The levels of TSH, anti-TPO and FT4 were estimated by supersensitive electrochemiluminiscent immunoassay using the automatic system Elecsys (Roche, Switzerland).
A total of 2786 adults was stratified into 7 groups according to the range of TSH level as related to generally recognized level of thyroid function, e.g. 1. TSH <0.10 mU/L (overt hyperthyroidism, N=41), 2. TSH 0.11-0.30 mU/L (overt or subclinical hyperthyroidism, N=149), 3. TSH 0.31-2.50 mU/L (normal level, N=1750), 4. TSH 2.51-4.50 ("high normal" level, N=607), 5 TSH 4.51-6.50 (mild or incipient subclinical hypothyroidism, N=137), 6. TSH 6.51-10.00 mU/L (mild hypothyroidism, N=50), 7. TSH 10.01-99.00 mU/L (severe hypothyroidism, N=53). The average levels of cholesterol in all groups were very similar ranging from 5.53 to 6.17 mmol/L and no interrelations with TSH level were found. In addition, no considerable differences between these groups were found when considering the levels of medians, upper quartiles and 90th percentiles of individual groups. When male and female subjects were divided into age groups according to the decades, an age dependent increase of cholesterol level was found in both sexes. The fraction of 2038 subjects was divided into the same TSH related groups as defined above. Similarly as above, no considerable differences in cholesterol, triglycerides and phospholipids level were observed. However, the levels of FT4 and TT3 were significantly decreasing with the increase of TSH level which confirmed the continuing decrease of thyroid function. The frequency of positive anti-TPO in subjects with TSH >6.5 mU/l (71/86 = 82.5%) was significantly higher than that in subjects with TSH <6.5 mU/l (468/1952 = 23.9%).
No difference in the level of cholesterol and triglycerides was found in large groups of rural adults from Slovakia with various thyroid function as estimated by the level of TSH, FT4, TT3 and anti-TPO. It is assumed that this interrelation resulted from very high cholesterol intake due to inappropriate general nutritional status of rural population resulting from the consumption of unhealthy foods.
在针对斯洛伐克农村人口甲状腺状况评估的大规模现场调查中,比较大量成年人血清胆固醇水平与由促甲状腺激素和游离甲状腺素水平所评估的甲状腺功能,并探讨甲状腺过氧化物酶抗体可能的参与情况。
共对2786名成年人的血清胆固醇和促甲状腺激素(TSH)水平进行了评估。此外,对其中2038人还检测了游离甲状腺素(FT4)、总三碘甲状腺原氨酸(TT3)、胆固醇、甘油三酯和磷脂水平。TSH、抗甲状腺过氧化物酶(anti - TPO)和FT4水平采用罗氏公司(瑞士)的Elecsys自动系统通过超敏电化学发光免疫分析法进行测定。
根据TSH水平范围与普遍认可的甲状腺功能水平相关,将2786名成年人分为7组,即1. TSH <0.10 mU/L(显性甲状腺功能亢进,N = 41);2. TSH 0.11 - 0.30 mU/L(显性或亚临床甲状腺功能亢进,N = 149);3. TSH 0.31 - 2.50 mU/L(正常水平,N = 1750);4. TSH 2.51 - 4.50(“高正常”水平,N = 607);5. TSH 4.51 - 6.50(轻度或初期亚临床甲状腺功能减退,N = 137);6. TSH 6.51 - 10.00 mU/L(轻度甲状腺功能减退,N = 50);7. TSH 10.01 - 99.00 mU/L(重度甲状腺功能减退,N = 53)。所有组的胆固醇平均水平非常相似,范围在5.53至6.17 mmol/L之间,未发现与TSH水平有相关性。此外,考虑各组中位数、上四分位数和第90百分位数水平时,这些组之间也未发现显著差异。当按年龄段将男性和女性受试者分组时,发现两性的胆固醇水平均随年龄增长而升高。将2038名受试者按上述与TSH相关的相同组进行划分。与上述情况类似,未观察到胆固醇、甘油三酯和磷脂水平有显著差异。然而,FT4和TT3水平随TSH水平升高而显著降低,这证实了甲状腺功能的持续下降。TSH >6.5 mU/l的受试者中抗TPO阳性频率(71/86 = 82.5%)显著高于TSH <6.5 mU/l的受试者(468/1952 = 23.9%)。
在斯洛伐克农村大量成年人中,根据TSH、FT4、TT3和抗TPO水平评估的不同甲状腺功能状态下,胆固醇和甘油三酯水平未发现差异。推测这种相互关系是由于农村人口不健康饮食导致总体营养状况不佳,胆固醇摄入量过高所致。