Toruner Fusun, Altinova Alev E, Karakoc Ayhan, Yetkin Ilhan, Ayvaz Goksun, Cakir Nuri, Arslan Metin
Department of Endocrinology and Metabolism, Gazi University, Faculty of Medicine, Ankara, Turkey.
Adv Ther. 2008 May;25(5):430-7. doi: 10.1007/s12325-008-0053-7.
The relationship between subclinical hypothyroidism (SCH) and cardiovascular disease is not fully understood. We investigated risk factors for cardiovascular disease (lipid profile, lipoproteins, insulin resistance, C-reactive protein [CRP] homocysteine [Hcy] and fibrinogen levels) and their relationships with thyroid hormones in SCH patients and controls.
Thirty-eight SCH patients and 44 controls were enrolled in this study. No patients had any substantial confounding medical conditions (including diabetes mellitus or coronary heart disease) or were taking thyroid-related medication.
Serum total cholesterol (P<0.05), low-density lipoprotein cholesterol (P<0.05) and triglycerides (P<0.001) were higher in patients with SCH than in controls. Serum lipoprotein(a) (Lp[a]) levels were higher in SCH subjects but this difference did not reach statistical significance (P=0.07). No significant differences were noted in CRP, Hcy, fibrinogen, high-density lipoprotein cholesterol, apolipoprotein A-1, apolipoprotein B (Apo B) or insulin resistance between patients with SCH and controls (in all cases, P>0.05). Free triiodothyronine (FT3) negatively correlated with Apo B (r=.0.46, P=0.005) and Lp(a) (r=.0.31, P=0.03) in patients with SCH and negatively correlated with Lp(a) (r=.0.30, P=0.04) in controls. All of these parameters were comparable between patients with thyroid-stimulating hormone (TSH) >10 microIU/ml and TSH <10 microIU/ml (in SCH patients, P>0.05).
Our results suggest that SCH is associated with some lipid and lipoprotein abnormalities. Our results also suggest that this association does not depend on the subject's TSH level.
亚临床甲状腺功能减退（SCH）与心血管疾病之间的关系尚未完全明确。我们调查了SCH患者和对照组心血管疾病的危险因素（血脂谱、脂蛋白、胰岛素抵抗、C反应蛋白[CRP]、同型半胱氨酸[Hcy]和纤维蛋白原水平）及其与甲状腺激素的关系。
本研究纳入了38例SCH患者和44例对照。所有患者均无严重的混杂性疾病（包括糖尿病或冠心病），且未服用甲状腺相关药物。
SCH患者的血清总胆固醇（P<0.05）、低密度脂蛋白胆固醇（P<0.05）和甘油三酯（P<0.001）高于对照组。SCH受试者的血清脂蛋白（a）[Lp（a）]水平较高，但差异无统计学意义（P=0.07）。SCH患者与对照组之间的CRP、Hcy、纤维蛋白原、高密度脂蛋白胆固醇、载脂蛋白A-1、载脂蛋白B（Apo B）或胰岛素抵抗无显著差异（所有情况，P>0.05）。SCH患者的游离三碘甲状腺原氨酸（FT3）与Apo B呈负相关（r=-0.46，P=0.005）和Lp（a）呈负相关（r=-0.31，P=0.03），对照组中FT3与Lp（a）呈负相关（r=-0.30，P=0.04）。促甲状腺激素（TSH）>10微国际单位/毫升和TSH<10微国际单位/毫升的患者之间所有这些参数均具有可比性（SCH患者中，P>0.05）。
我们的结果表明，SCH与一些脂质和脂蛋白异常有关。我们的结果还表明，这种关联不依赖于受试者的TSH水平。
