McGrowder D A, Fraser Y P, Gordon L, Crawford T V, Rawlins J M
Department of Pathology, The University of the West Indies, Mona, Kingston, West Indies.
Niger J Clin Pract. 2011 Oct-Dec;14(4):454-9. doi: 10.4103/1119-3077.91755.
There is the recognition of a pattern of elevations of serum enzymes in hyperthyroid and hypothyroid patients. The aims of this study were to determine the activities of serum creatine kinase (CK) and lactate deydrogenase (LDH) in thyroid disorders, and to evaluate the relationship between CK, LDH and FT4, and TSH levels.
In this retrospective study, thyroid function tests, serum CK and LDH activities were obtained from the medical records of newly diagnosed hyperthyroid and hypothyroid patients attending the Endocrinology Clinic at the University Hospital of the West Indies from 2005- 2009.
Elevation of CK activity was found in 5 patients (28%, 5/18) with overt hypothyroidism and in 12 patients (24.0%, 12/50) with subclinical hypothyroidism. The mean CK activity in subclinical hypothyroid patients was 179.80 ± 125.68 U/L compared with 389.901 ± 381.20 U/L in overt hypothyroid patients. The elevation of LDH activity was found in 6 patients (33.3%, 6/18) with overt hypothyroidism and in 37 patients (74.0%, 37/50) with subclinical hypothyroidism. In the hypothyroid patients, a positive correlation was found between CK activity and TSH (r = 0.292, P = 0.015), and a negative correlation between CK activity and FT4 (r = - 0.325, P = 0.007); and between FT4 and TSH (r = - 0.371, P = 0.002).
The significant elevation in serum CK and LDH activities indicates that these can be used as parameters for screening hypothyroid patients but not hyperthyroid patients.
甲状腺功能亢进和减退患者血清酶升高的模式已得到认可。本研究的目的是测定甲状腺疾病患者血清肌酸激酶(CK)和乳酸脱氢酶(LDH)的活性,并评估CK、LDH与FT4及促甲状腺激素(TSH)水平之间的关系。
在这项回顾性研究中,从2005年至2009年就诊于西印度群岛大学医院内分泌门诊的新诊断甲状腺功能亢进和减退患者的病历中获取甲状腺功能检查、血清CK和LDH活性数据。
在18例显性甲状腺功能减退患者中有5例(28%,5/18)CK活性升高,在50例亚临床甲状腺功能减退患者中有12例(24.0%,12/50)CK活性升高。亚临床甲状腺功能减退患者的平均CK活性为179.80±125.68 U/L,而显性甲状腺功能减退患者为389.901±381.20 U/L。在18例显性甲状腺功能减退患者中有6例(33.3%,6/18)LDH活性升高,在50例亚临床甲状腺功能减退患者中有37例(74.0%,37/50)LDH活性升高。在甲状腺功能减退患者中,CK活性与TSH之间呈正相关(r = 0.292,P = 0.015),CK活性与FT4之间呈负相关(r = - 0.325,P = 0.007);FT4与TSH之间也呈负相关(r = - 0.371,P = 0.002)。
血清CK和LDH活性的显著升高表明,这些指标可作为筛查甲状腺功能减退患者的参数,但不能用于筛查甲状腺功能亢进患者。