Department of Neuropsychiatry, Skaraborg Hospital, Falköping, Sweden.
Psychoneuroendocrinology. 2013 Jul;38(7):1058-66. doi: 10.1016/j.psyneuen.2012.10.012. Epub 2012 Nov 14.
Little is known of the association between thyroid hormones in the central nervous system and Alzheimer's disease (AD). We determined thyroid hormone levels in serum and cerebrospinal fluid (CSF) in a well-defined homogeneous mono-center population.
Fifty-nine consecutive patients under primary evaluation for cognitive impairment were recruited. The participants included patients with AD or mild cognitive impairment (MCI) diagnosed with AD upon follow-up (n=31), patients with stable MCI (SMCI, n=13), patients with other dementias (n=15), and healthy controls (n=19). Thyroid hormones in serum and CSF and AD biomarkers in CSF were analyzed using established immunochemical assays. Cognitive impairment was estimated using mini-mental state examination (MMSE).
Serum levels of free and total thyroxine (T4) and triiodothyronine (T3) were similar in all groups whereas a marginal increase in serum thyroid-stimulating hormone (TSH) level was observed in the AD patients. The CSF level of total T4 was decreased in patients with AD and other dementias compared to SMCI (both P=0.01) and healthy controls (both P=0.001), whereas CSF levels of TSH and total T3 were unchanged. In the total study population, CSF total T4 level correlated positively with MMSE score (r=0.26, P<0.05) and negatively with CSF total-tau (T-Tau) level (r=-0.23, P<0.05).
Patients with AD as well as other dementias had signs of mild brain hypothyroidism, which could only to a small extent be detected in serum values.
人们对中枢神经系统中的甲状腺激素与阿尔茨海默病（AD）之间的关系知之甚少。我们在一个明确的同质单中心人群中确定了血清和脑脊液（CSF）中的甲状腺激素水平。
招募了 59 名连续进行认知障碍初步评估的患者。参与者包括 AD 或轻度认知障碍（MCI）患者（根据随访诊断为 AD，n=31）、稳定 MCI（SMCI，n=13）、其他痴呆症患者（n=15）和健康对照组（n=19）。使用既定的免疫化学测定法分析血清和 CSF 中的甲状腺激素以及 CSF 中的 AD 生物标志物。使用简易精神状态检查（MMSE）评估认知障碍。
所有组的血清游离和总甲状腺素（T4）和三碘甲状腺原氨酸（T3）水平相似，而 AD 患者的血清促甲状腺激素（TSH）水平略有升高。与 SMCI（均 P=0.01）和健康对照组（均 P=0.001）相比，AD 和其他痴呆症患者的 CSF 总 T4 水平降低，而 CSF 中 TSH 和总 T3 水平不变。在整个研究人群中，CSF 总 T4 水平与 MMSE 评分呈正相关（r=0.26，P<0.05），与 CSF 总 tau（T-Tau）水平呈负相关（r=-0.23，P<0.05）。
AD 以及其他痴呆症患者存在轻度脑甲状腺功能减退的迹象，而在血清值中仅能检测到很小的程度。
