Kiso Y, Yoshida K, Kaise K, Kaise N, Fukazawa H, Mori K, Abe K, Yoshinaga K
Second Department of Internal Medicine, Tohoku University School of Medicine, Sendai, Japan.
J Clin Endocrinol Metab. 1991 Feb;72(2):515-8. doi: 10.1210/jcem-72-2-515.
We have recently reported that in patients with hyperthyroidism, red blood cell (RBC) zinc (Zn), most of which is present as the metal of carbonic anhydrase-I isozyme (CAI), reflects a patient's integrated thyroid hormone level over the previous few months. In the present report the RBC CAI concentration was measured by RIA in 26 healthy controls, 25 patients with hyperthyroid Graves' disease, 5 patients with primary hypothyroidism, and 10 subjects with subacute thyroiditis with elevated thyroid hormone levels. The mean (+/- SD) RBC CAI concentration in euthyroid controls was 380 +/- 70 nmol/g hemoglobin (Hb), and the normal range defined as the mean +/- 2 SD, was 240-520 nmol/g Hb. The mean RBC CAI in Graves' disease was decreased (180 +/- 53 nmol/g Hb), and 22 patients (88%) had subnormal values. The mean RBC CAI concentrations in hypothyroidism and subacute thyroiditis were not different from the control values. After treatment with antithyroid drugs, both mean the plasma T4 and T3 levels in 11 Graves' patients became normal within 4 weeks, but the normalization of RBC CAI lagged behind by about 2 months. Furthermore, the highest correlation was observed between the RBC CAI and plasma T4 and T3 levels measured 8 weeks earlier. During prednisolone therapy the RBC CAI in patients with subacute thyroiditis remained at a normal level. These results suggest that 1) not only RBC Zn but also the RBC CAI concentration in patients with Graves' disease reflect the patient's mean thyroid hormone level over the preceding several months; and 2) in patients with subacute thyroiditis, elevation of plasma thyroid hormone concentrations is transient and causes little change in the RBC CAI concentration.
我们最近报道，在甲状腺功能亢进患者中，红细胞（RBC）锌（Zn）大部分以碳酸酐酶-I同工酶（CAI）的金属形式存在，反映了患者过去几个月的综合甲状腺激素水平。在本报告中，通过放射免疫分析（RIA）测定了26名健康对照者、25名甲状腺功能亢进格雷夫斯病患者、5名原发性甲状腺功能减退患者和10名甲状腺激素水平升高的亚急性甲状腺炎患者的红细胞CAI浓度。甲状腺功能正常的对照者红细胞CAI浓度的平均值（±标准差）为380±70 nmol/g血红蛋白（Hb），定义为平均值±2标准差的正常范围为240 - 520 nmol/g Hb。格雷夫斯病患者的红细胞CAI平均值降低（180±53 nmol/g Hb），22名患者（88%）的值低于正常范围。甲状腺功能减退和亚急性甲状腺炎患者的红细胞CAI平均浓度与对照值无差异。11名格雷夫斯病患者经抗甲状腺药物治疗后，血浆T4和T3水平在4周内恢复正常，但红细胞CAI的正常化滞后约2个月。此外，观察到红细胞CAI与8周前测定的血浆T4和T3水平之间的相关性最高。在泼尼松龙治疗期间，亚急性甲状腺炎患者的红细胞CAI保持在正常水平。这些结果表明：1）格雷夫斯病患者不仅红细胞锌，而且红细胞CAI浓度反映了患者过去几个月的平均甲状腺激素水平；2）在亚急性甲状腺炎患者中，血浆甲状腺激素浓度的升高是短暂的，对红细胞CAI浓度影响很小。
