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健康老年人 2 型糖尿病患者的游离三碘甲状腺原氨酸和胆固醇水平。

Free Triiodothyronine and Cholesterol Levels in Euthyroid Elderly T2DM Patients.

机构信息

Endocrine Unit, INRCA, Via Cassia 1167, 00189 Rome, Italy.

出版信息

Int J Endocrinol. 2012;2012:420370. doi: 10.1155/2012/420370. Epub 2012 Sep 3.

Abstract

Thyroid function regulates lipid metabolism. Despite the fact that T2DM is more prevalent in the elderly, often associates with thyroid dysfunction and increases cardiovascular risk both per se and via high TC and LDL-C levels, the association of the latter with FT(3) and FT(4) levels has not yet been fully investigated in T2DM. While trying to fill this gap in 296 elderly outpatients with T2DM, we found that TC and LDL-C correlated negatively with FT(4) and positively with FT(3). When divided according to treatment by oral hypoglycaemic agents (OHA) and insulin (IT), they reacted differently with respect to investigated associations: in the OHA's TC and LDL-C correlated negatively with FT(4) and showed no association with FT(3), whereas, in the IT's TC and LDL-C correlated positively with FT(3) and negatively with FT(4). When controlled for possible confounding factors, these associations did not change in the IT's but were missing in the OHA's. Recent literature reports upon complex hypothalamic and peripheral interactions between T2DM and thyroid, and suggests T(3) to enhance cholesterol synthesis and to have a role in insulin resistance states. Further investigations are needed to understand the intimate mechanisms of lipid metabolism in T2DM with respect to thyroid function.

摘要

甲状腺功能调节脂代谢。尽管 2 型糖尿病在老年人中更为普遍,常与甲状腺功能障碍相关,并通过高 TC 和 LDL-C 水平增加心血管风险,但后者与 FT(3)和 FT(4)水平的关联在 2 型糖尿病中尚未得到充分研究。在试图填补 296 名老年 2 型糖尿病门诊患者的这一空白时,我们发现 TC 和 LDL-C 与 FT(4)呈负相关,与 FT(3)呈正相关。当根据口服降糖药 (OHA)和胰岛素 (IT)治疗进行分组时,它们对所研究的关联的反应不同:在 OHA 中,TC 和 LDL-C 与 FT(4)呈负相关,与 FT(3)无关,而在 IT 中,TC 和 LDL-C 与 FT(3)呈正相关,与 FT(4)呈负相关。在控制可能的混杂因素后,这些关联在 IT 中没有改变,但在 OHA 中却不存在。最近的文献报告了 2 型糖尿病和甲状腺之间复杂的下丘脑和外周相互作用,并表明 T(3)可增强胆固醇合成,并在胰岛素抵抗状态中发挥作用。需要进一步研究以了解甲状腺功能对 2 型糖尿病脂代谢的内在机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84dc/3438739/aef85aa06096/IJE2012-420370.001.jpg

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