Cakal Başak, Cakal Erman, Demirbaş Berrin, Ozkaya Mesut, Karaahmetoğlu Selma, Serter Rüştü, Aral Yalçin
Ankara Numune Education and Research Hospital, Department of Internal Medicine, Ankara, Turkey.
J Korean Med Sci. 2007 Jun;22(3):431-5. doi: 10.3346/jkms.2007.22.3.431.
The aim of the present study was to evaluate plasma total homocysteine (Hcys) and serum fibrinogen concentrations in subclinical hypothyroid (SH) and overt hypothyroid patients before and after L-thyroxine (LT4) replacement and to compare them in euthyroid subjects. Fifteen SH and 20 hypothyroid premenopausal women were recruited in the study. We measured fasting plasma levels of Hcys and serum levels of free thyroxine (fT4), free triiodothyronine (fT3), thyrotropin (TSH), folate, vitamin B12, fibrinogen, renal functions, and lipid profiles in patients with SH and overt hypothyroid patients before and after LT4 treatment. Eleven healthy women were included in the study as a control group. Pretreatment Hcys levels were similar in SH and control subjects, whereas mean fibrinogen level of SH patients was higher than that of control subjects (p<0.05). Baseline Hcys (p<0.01) and fibrinogen (p<0.001) levels of the overt hypothyroid patients were significantly higher than those of the healthy subjects, and the pretreatment Hcys levels decreased with LT4 treatment (p<0.001). In conclusion, our data support that SH is not associated with hyperhomocysteinemia and Hcys does not appear to contribute to the increased risk for atherosclerotic disease in patients with SH.
本研究的目的是评估亚临床甲状腺功能减退（SH）和显性甲状腺功能减退患者在左甲状腺素（LT4）替代治疗前后的血浆总同型半胱氨酸（Hcys）和血清纤维蛋白原浓度，并与甲状腺功能正常的受试者进行比较。本研究招募了15名SH患者和20名甲状腺功能减退的绝经前女性。我们测量了SH患者和显性甲状腺功能减退患者在LT4治疗前后的空腹血浆Hcys水平、血清游离甲状腺素（fT4）、游离三碘甲状腺原氨酸（fT3）、促甲状腺激素（TSH）、叶酸、维生素B12、纤维蛋白原、肾功能和血脂谱。11名健康女性作为对照组纳入研究。SH患者和对照组受试者的治疗前Hcys水平相似，而SH患者的平均纤维蛋白原水平高于对照组（p<0.05）。显性甲状腺功能减退患者的基线Hcys（p<0.01）和纤维蛋白原（p<0.001）水平显著高于健康受试者，且LT4治疗后治疗前Hcys水平降低（p<0.001）。总之，我们的数据支持SH与高同型半胱氨酸血症无关，且Hcys似乎不会增加SH患者患动脉粥样硬化疾病的风险。
