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[使用双能X线吸收法对甲状腺功能障碍患者身体成分的评估]

[The assessment of body composition using DEXA in patients with thyroid dysfunction].

作者信息

Brunová J, Kasalický P, Lánská V

机构信息

Centrum diabetologie IKEM, Praha.

出版信息

Cas Lek Cesk. 2007;146(5):497-502.

Abstract

BACKGROUND

Disturbed thyroid function is accompanied with weight changes in most of patients. Less is known how the therapy of hyperthyroidism and hypothyroidism influences their body composition.

METHODS AND RESULTS

We investigated 18 persons with newly diagnosed hyperthyroidism (group I), 15 persons with newly diagnosed hypothyroidism (group II), 22 persons with long-lasting well-controlled primary hypothyroidism (group II) and 17 persons with history of cured hyperthyroidism (group IV). Body composition, including percentage of body fat, was examined with Dual energy absorptiometry method (DXA; GE Lunar prodigy). There was no significant difference in age, BMI, and % of body fat between groups. Group I had mean levels of free T4: 43.1+/-20.1 pmol/L, and TSH 0.03+/-0.05 mU/L. Mean values of TSH 28.55+/-20.64 mU/L and free T4 5.94+/-2.27 pmol/L were in accordance with the diagnosis of untreated hypothyroidism in group II. Thyroid function in groups III and IV was within normal limits. The mean weight gain in group I was 3.9 kg and their BMI increased from 25.78+/-3.73 kg/m(2) to 27.36+4.03 kg/m(2) after the therapy (p=0.023). BMI has not changed significantly in group II after the normalization of thyroid function, nor in group II and III. A significant parallel increase in the total body fat (26737+/-6993 g vs. 31277+/-8735 g), (p=0.0078) as well as in lean mass (43936+/-9886 g vs 51065+/-9501 g) (p= 0.0156) was observed only in group I after therapy. There was no increase in percentage of body fat (38.04+/-8.6% vs.38.0+/-9.8%) (NS). The body composition did not changed in the other patients treated during the follow-up.

CONCLUSIONS

Normalization of thyroid function of newly diagnosed hyperthyroid patients caused the parallel increase in their fat mass and lean body mass, assed with DXA. Percentage of fat mass did not change significantly after the treatment. Correction of hypothyroidism did not lead to the body composition changes; patients did not show any weight loss either.

摘要

背景

大多数患者甲状腺功能紊乱伴有体重变化。关于甲亢和甲减的治疗如何影响其身体成分,人们了解较少。

方法与结果

我们调查了18例新诊断为甲亢的患者(I组)、15例新诊断为甲减的患者(II组)、22例长期甲状腺功能控制良好的原发性甲减患者(III组)以及17例有甲亢治愈史的患者(IV组)。采用双能吸收法(DXA;GE Lunar prodigy)检测身体成分,包括体脂百分比。各组之间在年龄、体重指数和体脂百分比方面无显著差异。I组游离T4平均水平为43.1±20.1 pmol/L,促甲状腺激素(TSH)为0.03±0.05 mU/L。II组TSH平均值为28.55±20.64 mU/L,游离T4为5.94±2.27 pmol/L,符合未经治疗的甲减诊断。III组和IV组甲状腺功能在正常范围内。I组治疗后平均体重增加3.9 kg,体重指数从25.78±3.73 kg/m²增加到27.36±4.03 kg/m²(p = 0.023)。II组甲状腺功能正常化后体重指数无显著变化,III组和IV组也无变化。仅I组治疗后全身脂肪量(26737±6993 g对31277±8735 g)(p = 0.0078)以及去脂体重(43936±9886 g对51065±9501 g)(p = 0.0156)有显著平行增加。体脂百分比无增加(38.04±8.6%对38.0±9.8%)(无统计学意义)。随访期间接受治疗的其他患者身体成分未发生变化。

结论

新诊断甲亢患者甲状腺功能正常化导致其脂肪量和去脂体重平行增加,通过DXA评估。治疗后体脂百分比无显著变化。纠正甲减未导致身体成分改变;患者也未出现体重减轻。

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