Guzel Savas, Seven Arzu, Guzel Eda Celik, Buyuk Banu, Celebi Aslan, Aydemir Birsen
a Medical Faculty, Department of Biochemistry, Namik Kemal University , Tekirdag, Turkey.
b Cerrahpasa Medical Faculty, Department of Biochemistry, Istanbul University , Istanbul, Turkey.
Endocr Res. 2013 Aug;38(3):184-194. doi: 10.3109/07435800.2012.760588. Epub 2013 Jan 16.
This study is designed to evaluate the interrelationships among adipokines-visfatin, leptin, and tumor necrosis factor-α (TNF-α)- and insulin resistance (IR) in overt (n = 40) and subclinic hypothyroid (n = 25) patients and compare our findings with sex and body mass index-matched healthy controls (n = 25).
Serum visfatin, leptin, and TNF-α levels were measured by enzyme-linked immunosorbent assay and C-reactive protein by immunoturbidimetry. Thyroid status (TSH, FT3, FT4) and lipid status (triglyceride, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, total cholesterol) parameters were measured. IR was determined by homeostatic model assessment (HOMA-IR) and McAuley (McA) indices.
HOMA-IR (p < 0.05) and McA indices (p < 0.01) revealed the presence of IR in overt hypothyroid patients. C-reactive protein, TNF-α, leptin, and visfatin levels were significantly higher (p < 0.01, p < 0.01, p < 0.001, and p < 0.001) in overt hypothyroid patients than euthyroid control group. Subclinic hypothyroid patients were observed to have significantly higher leptin and visfatin levels (p < 0.05) than euthyroid control group. In overt hypothyroid patients, we found plasma visfatin to be significantly positively correlated with HOMA-IR index (r = 0.336, p < 0.05) and body mass index (r = 0.445, p < 0.01) and negatively correlated with McA index (r = -0.574, p < 0.01).
This study demonstrates the presence of IR in overt hypothyroid patients by HOMA and McA indices. Increased levels of visfatin, leptin, and TNF-α in overt and subclinic hypothyroid patients and the correlations among these adipokines highlighten their crucial role in the IR-associated disorders.
本研究旨在评估显性甲状腺功能减退患者（n = 40）和亚临床甲状腺功能减退患者（n = 25）体内脂肪因子——内脂素、瘦素和肿瘤坏死因子-α（TNF-α）与胰岛素抵抗（IR）之间的相互关系，并将我们的研究结果与性别和体重指数匹配的健康对照组（n = 25）进行比较。
采用酶联免疫吸附测定法测量血清内脂素、瘦素和TNF-α水平，采用免疫比浊法测量C反应蛋白。测量甲状腺状态（促甲状腺激素、游离三碘甲状腺原氨酸、游离甲状腺素）和血脂状态（甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、总胆固醇）参数。通过稳态模型评估（HOMA-IR）和麦考利（McA）指数确定IR。
HOMA-IR（p < 0.05）和McA指数（p < 0.01）显示显性甲状腺功能减退患者存在IR。显性甲状腺功能减退患者的C反应蛋白、TNF-α、瘦素和内脂素水平显著高于甲状腺功能正常的对照组（p < 0.01、p < 0.01、p < 0.001和p < 0.001）。观察发现亚临床甲状腺功能减退患者的瘦素和内脂素水平显著高于甲状腺功能正常的对照组（p < 0.05）。在显性甲状腺功能减退患者中，我们发现血浆内脂素与HOMA-IR指数显著正相关（r = 0.336，p < 0.05）和体重指数（r = 0.445，p < 0.01），与McA指数负相关（r = -0.574，p < 0.01）。
本研究通过HOMA和McA指数证明显性甲状腺功能减退患者存在IR。显性和亚临床甲状腺功能减退患者体内内脂素、瘦素和TNF-α水平升高，以及这些脂肪因子之间的相关性突出了它们在IR相关疾病中的关键作用。
