Manuchehri Alireza M, Jayagopal Vijay, Kilpatrick Eric S, Atkin Stephen L
Department of Diabetes & Endocrinology, University of Hull, Hull, UK.
Ann Clin Biochem. 2006 May;43(Pt 3):184-8. doi: 10.1258/000456306776865089.
B-type natriuretic peptides and N-terminal pro-B-type natriuretic peptides (NT-proBNP) have been suggested as being useful for the diagnosis of congestive heart failure. We have shown previously that changes in thyroid function are associated with changes in concentrations of other low molecular weight molecules. Therefore, the aim of this study was to assess whether similar changes occurred with NT-proBNP concentrations following treatment of thyroid dysfunction.
Seventeen patients (12 female, 5 male, age range 24-77 years) with newly diagnosed hypothyroidism and 21 patients (16 female, 5 male, age range 21-66 years) with newly diagnosed hyperthyroidism had NT-proBNP measured at baseline and when they subsequently became euthyroid.
NT-proBNP levels were not significantly different in the hyperthyroid group from the hypothyroid, either before (P = 0.706) or after treatment to euthyroidism (P = 0.170). The hypothyroid group showed a rise in NT-proBNP after treatment (P < 0.001). There was a marginally significant fall in the NT-proBNP levels in the hyperthyroid group (P = 0.05). However, these changes were within the expected wide range of biological variability of NT-proBNP shown in earlier studies.
Hypothyroidism alters NT-proBNP concentrations, but the magnitude of this effect may be lost in the wide biological variability of natriuretic peptides and this statistically significant finding is not likely to be of clinical relevance.
B型利钠肽和N末端B型利钠肽原(NT-proBNP)已被认为对充血性心力衰竭的诊断有用。我们之前已经表明,甲状腺功能的变化与其他低分子量分子浓度的变化有关。因此,本研究的目的是评估甲状腺功能障碍治疗后NT-proBNP浓度是否发生类似变化。
对17例新诊断为甲状腺功能减退的患者(12例女性,5例男性,年龄范围24 - 77岁)和21例新诊断为甲状腺功能亢进的患者(16例女性,5例男性,年龄范围21 - 66岁)在基线时以及随后甲状腺功能恢复正常时测量NT-proBNP。
甲状腺功能亢进组与甲状腺功能减退组在治疗前(P = 0.706)和治疗至甲状腺功能正常后(P = 0.170)的NT-proBNP水平均无显著差异。甲状腺功能减退组治疗后NT-proBNP升高(P < 0.001)。甲状腺功能亢进组NT-proBNP水平略有下降(P = 0.05)。然而,这些变化在早期研究显示的NT-proBNP预期的广泛生物学变异范围内。
甲状腺功能减退会改变NT-proBNP浓度,但这种影响的程度可能在利钠肽广泛的生物学变异中消失,并且这一具有统计学意义的发现不太可能具有临床相关性。