Mittal Ankush, Poudel Bibek, Pandeya Dipendra Raj, Gupta Satrudhan Pd, Sathian Brijesh, Yadav Shambhu Kumar
Department of Biochemistry, Nepalese Army Institute of Health Sciences, Kathmandu, Manipal College of Medical Sciences, Pokhara, Nepal.
Asian Pac J Cancer Prev. 2012;13(5):2335-8. doi: 10.7314/apjcp.2012.13.5.2335.
To evaluate several metabolic changes in patients with differentiated thyroid carcinoma (DTC ) which enhance cardiovascular risk in the western region of Nepal.
This hospital based case control study was carried out using data retrieved from the register maintained in the Department of Biochemistry of the Manipal Teaching Hospital, Pokhara, Nepal between 1st January, 2009 and 31st December, 2011. The variables collected were age, gender, BMI, glucose, insulin, HbA1C, CRP, fibrinogen, total cholesterol, triglycerides, HDL, LDL, VLDL, f-T3, f-T4, TSH. One way ANOVA was used to examine statistical significance of differences between groups, along with the Post Hoc test LSD for comparison of means.
fT3 values were markedly raised in DTC cases (5.7±SD1.4) when compared to controls (2.2±SD0.9). Similarly, fT4 values were also moderately raised in cases of DTC (4.9±SD1.3 and 1.7 ±SD0.9). In contrast, TSH values were lowered in DTC cases (0.39±SD0.4) when compared to controls (4.2 ±SD 1.4). Mean blood glucose levels were decreased while insulin was increased and HDL reduced (39.5±SD4.7 as compared to the control 43.1±SD2.2).
Cardiovascular risk may be aggravated by insulin resistance, a hypercoagulable state, and an atherogenic lipid profile in patients with differentiated thyroid cancer.
评估尼泊尔西部地区分化型甲状腺癌（DTC）患者的几种代谢变化，这些变化会增加心血管疾病风险。
本基于医院的病例对照研究使用了从尼泊尔博卡拉马尼帕尔教学医院生物化学科2009年1月1日至2011年12月31日所保存的登记册中检索到的数据。收集的变量包括年龄、性别、体重指数、血糖、胰岛素、糖化血红蛋白、C反应蛋白、纤维蛋白原、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、极低密度脂蛋白、游离三碘甲状腺原氨酸、游离甲状腺素、促甲状腺激素。采用单因素方差分析来检验组间差异的统计学意义，并使用LSD事后检验进行均值比较。
与对照组（2.2±标准差0.9）相比，DTC病例的游离三碘甲状腺原氨酸（fT3）值显著升高（5.7±标准差1.4）。同样，DTC病例的游离甲状腺素（fT4）值也有中度升高（4.9±标准差1.3和1.7±标准差0.9）。相比之下，与对照组（4.2±标准差1.4）相比，DTC病例的促甲状腺激素（TSH）值降低（0.39±标准差0.4）。平均血糖水平降低，而胰岛素升高，高密度脂蛋白降低（与对照组43.1±标准差2.2相比为39.5±标准差4.7）。
分化型甲状腺癌患者的胰岛素抵抗、高凝状态和致动脉粥样硬化血脂谱可能会加重心血管疾病风险。
