Department of Endocrinology and Metabolism, Dicle University, Faculty of Medicine, Diyarbakir, Turkey.
Eur J Intern Med. 2012 Sep;23(6):e141-5. doi: 10.1016/j.ejim.2012.05.007. Epub 2012 Jun 2.
Lipid alterations in overt hypothyroidism (OH) were well known, but its changes in subclinical hypothyroidism (SCH) and postprandial period were not clear. The aim of this study is to evaluate postprandial lipemia by oral lipid tolerance test (OLTT) in patients with OH and SCH.
Twenty-five OH and 27 SCH, totally 52 hypothyroid patients [mean age 38.3 ± 12.8 year, body mass index (BMI): 29.0 ± 5.8 kg/m(2)] and 23 BMI- and age-matched healthy controls (mean age 36.7 ± 11.9 years; BMI: 27.1 ± 6.9 kg/m(2)) were included to the study. Anthropometric measurements and HOMA-IR levels were measured. Basal and postprandial lipid profile at 2nd, 4th, 6th and 8th hours were determined by oral lipid tolerance test.
There were not any statistical differences among three groups (control, OH and SCH) in terms of mean fasting levels of total cholesterol, LDL-cholesterol, VLDL-cholesterol, and triglyceride. On the contrary, mean triglyceride levels at postprandial 8th hour in both OH and SCH patients were higher than control subjects (p=0.017 and p=0.049, respectively). Again mean postprandial 8th hour VLDL-cholesterol levels in OH group were also higher than control subjects (p=0.05). In addition mean HOMA-IR value of SCH and OH patients was similar with control subjects (1.5 ± 1.4 in OH; 1.3 ± 0.8 in SCH; 2.2 ± 2.2 in control group).
Although total, LDL and VLDL-cholesterol, and triglyceride levels were not different from healthy controls, triglyceride and/or VLDL-cholesterol levels apparently increased with OLTT in both OH and SCH patients. Decreased lipid clearance may be responsible for this result.
显性甲状腺功能减退症(OH)患者的脂类改变已众所周知,但亚临床甲状腺功能减退症(SCH)和餐后脂类改变尚不明确。本研究旨在通过口服脂质耐量试验(OLTT)评估 OH 和 SCH 患者的餐后脂血症。
共纳入 52 例甲状腺功能减退症患者(平均年龄 38.3 ± 12.8 岁,体重指数 [BMI]:29.0 ± 5.8 kg/m2),包括 25 例 OH 患者和 27 例 SCH 患者,以及 23 例 BMI 和年龄匹配的健康对照者(平均年龄 36.7 ± 11.9 岁,BMI:27.1 ± 6.9 kg/m2)。测量人体测量学指标和 HOMA-IR 水平。通过 OLTT 测定第 2、4、6 和 8 小时的基础和餐后血脂谱。
三组(对照组、OH 组和 SCH 组)的空腹总胆固醇、LDL-胆固醇、VLDL-胆固醇和甘油三酯的平均水平无统计学差异。相反,OH 和 SCH 患者的餐后 8 小时甘油三酯水平均高于对照组(p=0.017 和 p=0.049)。此外,OH 组的餐后 8 小时 VLDL-胆固醇水平也高于对照组(p=0.05)。另外,SCH 和 OH 患者的平均 HOMA-IR 值与对照组相似(OH 组为 1.5 ± 1.4,SCH 组为 1.3 ± 0.8,对照组为 2.2 ± 2.2)。
尽管总胆固醇、LDL 和 VLDL-胆固醇及甘油三酯水平与健康对照组无差异,但 OLTT 后 OH 和 SCH 患者的甘油三酯和/或 VLDL-胆固醇水平明显升高。脂类清除减少可能是造成这一结果的原因。