甲状腺功能亢进症治疗前后卡比马唑对体重平衡及其调节剂的影响。

Weight homeostasis & its modulators in hyperthyroidism before & after treatment with carbimazole.

机构信息

Department of Endocrinology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.

出版信息

Indian J Med Res. 2012 Aug;136(2):242-8.

DOI:

PMID:22960891

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3461736/

Abstract

BACKGROUND & OBJECTIVES: Hyperthyroidism is associated with increased food intake, energy expenditure and altered body composition. This study was aimed to evaluate the role of adipocytokines in weight homeostasis in patients with hyperthyroidism.

METHODS

Patients (n=27, 11men) with hyperthyroidism (20 Graves' disease, 7 toxic multinodular goiter) with mean age of 31.3±4.2 yr and 28 healthy age and body mass index (BMI) matched controls were studied. They underwent assessment of lean body mass (LBM) and total body fat (TBF) by dual energy X-ray absorptiometer (DXA) and blood sample was taken in the fasting state for measurement of leptin, adiponectin, ghrelin, insulin, glucose and lipids. Patients were re-evaluated after 3 months of treatment as by that time all of them achieved euthyroid state with carbimazole therapy.

RESULTS

The LBM was higher (P<0.001) in healthy controls as compared to hyperthyroid patients even after adjustment for body weight (BW), whereas total body fat was comparable between the two groups. Serum leptin levels were higher in patients with hyperthyroidism than controls (22.3±3.7 and 4.1±0.34 ng/ml, P<0.001), whereas adiponectin levels were comparable. Plasma acylated ghrelin was higher in patients than in controls (209.8±13.3 vs 106.2±8.2 pg/ml, P<0.05). Achievement of euthyroidism was associated with significant weight gain (P<0.001) and significant increase in lean body mass (P<0.001). The total body fat also increased but insignificantly from 18.4±1.8 to 19.9±1.8 kg. There was significant decrease (P<0.05) in serum leptin and acylated ghrelin but adiponectin levels remained unaltered after treatment. Serum leptin positively correlated with TBF and this correlation persisted even after adjustment for BW, BMI, gender and age (r=0.62, P=0.001). However, serum leptin and acylated ghrelin did not correlate with the presence or absence of hyperphagia.

INTERPRETATION & CONCLUSION: Patients with hyperthyroidism predominantly had decreased lean body mass which increased after achievement of euthyroidism with carbimazole. The hyperphagia and the alterations in weight homeostasis associated with hyperthyroidism were independent of circulating leptin and ghrelin levels.

摘要

背景与目的

甲状腺功能亢进症与食物摄入增加、能量消耗和身体成分改变有关。本研究旨在评估脂肪细胞因子在甲状腺功能亢进症患者体重平衡中的作用。

方法

研究了 27 名甲状腺功能亢进症患者（20 名 Graves 病，7 名毒性多结节性甲状腺肿）和 28 名年龄和体重指数（BMI）匹配的健康对照者。他们接受了双能 X 射线吸收仪（DXA）检查，以评估瘦体重（LBM）和全身脂肪（TBF），空腹采血测量瘦素、脂联素、胃饥饿素、胰岛素、血糖和血脂。患者在接受卡比马唑治疗 3 个月后进行了重新评估，因为此时所有患者均达到了甲状腺功能正常状态。

结果

即使在调整体重（BW）后，健康对照组的 LBM 也明显高于甲状腺功能亢进症患者（P<0.001），而两组的总体脂无差异。与对照组相比，甲状腺功能亢进症患者的血清瘦素水平较高（22.3±3.7 和 4.1±0.34 ng/ml，P<0.001），而脂联素水平无差异。与对照组相比，患者的酰化胃饥饿素水平较高（209.8±13.3 与 106.2±8.2 pg/ml，P<0.05）。达到甲状腺功能正常状态与体重显著增加（P<0.001）和瘦体重显著增加（P<0.001）有关。总体脂也有所增加，但无统计学意义，从 18.4±1.8 增加到 19.9±1.8 kg。治疗后，血清瘦素和酰化胃饥饿素水平显著下降（P<0.05），但脂联素水平无变化。血清瘦素与 TBF 呈正相关，即使在调整 BW、BMI、性别和年龄后，这种相关性仍然存在（r=0.62，P=0.001）。然而，血清瘦素和酰化胃饥饿素与是否存在多食症无关。