Cakir M, Kayacetin E, Toy H, Bozkurt S
Meram School of Medicine, Division of Endocrinology and Metabolism, Selcuk University, Konya, Turkey.
Exp Clin Endocrinol Diabetes. 2009 Sep;117(8):395-9. doi: 10.1055/s-0029-1202850. Epub 2009 Apr 16.
Hypothyroidism and hyperthyroidism are known to affect cholesterol metabolism, bile acid synthesis and bile content. There are previous studies reporting increased prevalence of gallstone and common bile duct stone formation in hypothyroidism. The aim of this study was to compare gallbladder (GB) motor function between euthyroid, hypothyroid and hyperthyroid subjects by conventional ultrasonography. Eighteen euthyroid, 14 hypothyroid and 20 hyperthyroid, age, sex and body mass index matched subjects were included in the study. Etiology of hypothyroidism comprised of thyroidectomy, Hashimoto's thyroiditis and previous radioactive iodine therapy. Hyperthyroid group included patients with toxic nodular goitre and Graves' disease. Patients who have diseases or are under drug treatment known to affect biliary function were not included in the study. Fasting and post-stimulus GB volumes were measured by real-time conventional ultrasonography and computer unit (Aloka UST-979, 3.5 mHz electronic convex probe, Japan). No significant differences were noted for fasting, post-stimulus GB volumes and GB ejection fraction between euthyroid, hypothyroid and hyperthyroid subjects. Measuring GB motility accurately is not straightforward because besides being not static during fasting, after a meal, intermittent emptying and refilling of GB occurs. Ultrasonography is affected by GB filling and measures "net" GB emptying. Although cumbersome, additional evaluation with cholescintigraphy which detects "absolute" GB emptying and is not affected by GB filling may provide complete assessment of motor function and may be more informative in evaluating subjects with different thyroid hormone status.
已知甲状腺功能减退和甲状腺功能亢进会影响胆固醇代谢、胆汁酸合成及胆汁成分。既往有研究报告称甲状腺功能减退患者胆囊结石和胆总管结石形成的患病率增加。本研究的目的是通过传统超声检查比较甲状腺功能正常、减退和亢进受试者的胆囊（GB）运动功能。本研究纳入了18例甲状腺功能正常、14例甲状腺功能减退和20例甲状腺功能亢进且年龄、性别和体重指数匹配的受试者。甲状腺功能减退的病因包括甲状腺切除术、桥本甲状腺炎和既往放射性碘治疗。甲状腺功能亢进组包括毒性结节性甲状腺肿和格雷夫斯病患者。患有已知会影响胆汁功能的疾病或正在接受药物治疗的患者未纳入本研究。通过实时传统超声检查和计算机装置（日本Aloka UST - 979，3.5 mHz电子凸阵探头）测量空腹和刺激后胆囊容积。甲状腺功能正常、减退和亢进受试者在空腹、刺激后胆囊容积及胆囊排空分数方面未发现显著差异。准确测量胆囊运动并不简单，因为胆囊在空腹时并非静止不动，进食后会间歇性排空和再充盈。超声检查受胆囊充盈情况影响，测量的是胆囊“净”排空。尽管繁琐，但用检测“绝对”胆囊排空且不受胆囊充盈影响的胆闪烁显像进行额外评估，可能会提供对运动功能的完整评估，并且在评估不同甲状腺激素状态的受试者时可能更具信息价值。
