Department of Endocrinology and Internal Medicine, Medical University, Gdansk, Poland.
Endokrynol Pol. 2009 Nov-Dec;60(6):443-8.
Hyperhomocysteinaemia is an independent risk factor for premature atherosclerotic vascular disease and venous thrombosis. Hypothyroidism is associated with mild hyperhomocysteinaemia. The aim of the present study was to assess plasma total homocysteine (tHcy) and its determinants (folate, cobalamin) in hyperthyroid patients before and after treatment.
Thirty hyperthyroid and thirty healthy premenopausal women were studied. The hyperthyroid patients were investigated in the untreated state and again after restoration of euthyroidism. The levels of homocysteine, folate, cobalamin, and thyroid stimulating hormone (TSH), free thyroxine (fT(4)), free triiodothyronine (fT(3)), and renal function were measured before and after treatment.
In hyperthyroidism, tHcy was lower than in the control group. The serum level of folate was higher and serum cobalamin was lower in the hyperthyroid state. Following antithyroid drug therapy, tHcy significantly increased and folate decreased. The level of cobalamin remained unchanged. Univariate analysis in the hyperthyroid group indicated that tHcy significantly negatively correlated only with fT(3).
Lower homocysteine levels in hyperthyroid state can be explained by the influence of thyroid hormone. High level of folate is only partially responsible for these changes.
高同型半胱氨酸血症是早发动脉粥样硬化性血管疾病和静脉血栓形成的独立危险因素。甲状腺功能减退与轻度高同型半胱氨酸血症相关。本研究旨在评估甲状腺功能亢进患者治疗前后的血浆总同型半胱氨酸（tHcy）及其决定因素（叶酸、钴胺素）。
研究了 30 例甲状腺功能亢进和 30 例健康绝经前妇女。甲状腺功能亢进患者在未治疗状态和甲状腺功能恢复正常后进行了研究。在治疗前后测量了同型半胱氨酸、叶酸、钴胺素、促甲状腺激素（TSH）、游离甲状腺素（fT（4））、游离三碘甲状腺原氨酸（fT（3））和肾功能的水平。
在甲状腺功能亢进中，tHcy 低于对照组。甲状腺功能亢进状态下血清叶酸水平升高，血清钴胺素水平降低。抗甲状腺药物治疗后，tHcy 显著升高，叶酸降低。钴胺素水平保持不变。甲状腺功能亢进组的单因素分析表明，tHcy 仅与 fT（3）显著负相关。
甲状腺功能亢进状态下同型半胱氨酸水平较低可归因于甲状腺激素的影响。高叶酸水平仅部分解释了这些变化。
