G D Xiang, J H Pu, H L Sun, L S Zhao
Department of Endocrinology, Wuhan General Hospital of Guangzhou Command, Hubei Province, PR China.
Exp Clin Endocrinol Diabetes. 2010 Oct;118(9):625-9. doi: 10.1055/s-0029-1237702. Epub 2010 Feb 16.
Many studies showed that impairment of flow-mediated endothelium-dependent arterial dilation (FMD) exists in patients with subclinical hypothyroidism (sHT). The crucial mechanism of this endothelial dysfunction remain unclear. We hypothesized that oxidative stress may be partially responsible for the impairment in FMD in patients with sHT. Thus, the present study was designed to assess whether the antioxidant alpha-lipoic acid can improve endothelial dysfunction in patients with sHT.
Forty women with newly diagnosed sHT and 18 healthy women with euthyroid status were enrolled. Patients were randomized into 2 groups to receive no treatment (n = 20), alpha-lipoic acid (n = 20) for 3 weeks. We measured the FMD at baseline and after 3 weeks.
FMD in alpha-lipoic acid and no-treatment group were 3.92% and 4.02%, respectively, which were significantly lower than that in controls (5.64%) (p<0.001). After 3 weeks treatment, compared with before treatment in sHT patients, plasma thiobarbituric acid reactive substances (TBARS) levels decreased significantly in alpha-lipoic acid group (p<0.001), and remain unchanged in no-treatment group (p>0.05). FMD improved markedly (4.82%) in alpha-lipoic acid group (p<0.01), and remain unchanged in no-treatment group (p>0.05). The absolute changes in FMD showed significant negative correlation with the changes in TBARS (r = -0.773, p<0.001).
Our data showed that sHT patients exists impaired endothelial function, and antioxidant alpha-lipoic acid can improve endothelial function, through decrease of oxygen- derived free radicals.
许多研究表明,亚临床甲状腺功能减退症(sHT)患者存在血流介导的内皮依赖性动脉扩张(FMD)受损。这种内皮功能障碍的关键机制尚不清楚。我们推测氧化应激可能部分导致sHT患者FMD受损。因此,本研究旨在评估抗氧化剂α-硫辛酸是否能改善sHT患者的内皮功能障碍。
纳入40例新诊断的sHT女性患者和18例甲状腺功能正常的健康女性。患者被随机分为2组,分别接受不治疗(n = 20)、α-硫辛酸治疗(n = 20),为期3周。我们在基线和3周后测量FMD。
α-硫辛酸组和不治疗组的FMD分别为3.92%和4.02%,显著低于对照组(5.64%)(p<0.001)。治疗3周后,与治疗前相比,sHT患者中,α-硫辛酸组血浆硫代巴比妥酸反应性物质(TBARS)水平显著降低(p<0.001),不治疗组则保持不变(p>0.05)。α-硫辛酸组FMD显著改善(4.82%)(p<0.01),不治疗组保持不变(p>0.05)。FMD的绝对变化与TBARS的变化呈显著负相关(r = -0.773,p<0.001)。
我们的数据表明,sHT患者存在内皮功能受损,抗氧化剂α-硫辛酸可通过减少氧衍生自由基来改善内皮功能。