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急性甲状腺功能减退对无甲状腺患者血脂水平的影响。

The impact of acute hypothyroidism on lipid levels in athyreotic patients.

作者信息

Salehidoost Rezvan, Aminorroaya Ashraf, Iraj Bijan, Amini Massoud

机构信息

Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

J Res Med Sci. 2012 Aug;17(8):724-7.

Abstract

BACKGROUND

We investigated the effect of acute hypothyroidism on lipid concentrations especially on high density lipoprotein (HDL-cholesterol) level in athyroatic patients.

MATERIALS AND METHODS

Thirty-one patients, with a history of differentiated thyroid carcinoma and total thyroidectomy, who were candidates of radioiodine therapy, enrolled in the study. Their lipid profiles and serum thyrotropin stimulating hormone (TSH) levels were measured before and two-to-six weeks after thyroid hormone withdrawal. The lipid concentrations were compared with the paired t test and serum TSH using the Wilcoxon singed rank test. P values < 0.05 were considered statistically significant.

RESULTS

The median of TSH concentration was 0.06 mU / liter on thyroid hormone suppressive therapy and 102 mU / liter at the thyroid hormone withdrawal phase (P < 0.0001). The serum concentrations of all lipids were significantly increased after withdrawal (P < 0.0001). The mean (SD) of the HDL-cholesterol concentration rose from 44 ± 9 mg / dL to 58 ± 17 mg / dL. The levels of total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride increased by 58, 75, 30, and 59%, respectively, during acute hypothyroidism.

CONCLUSION

The present study showed that thyroid hormone withdrawal altered the lipid concentrations significantly, in a short period of time. The levels of both atherogenic (LDL-cholesterol) and cardioprotective (HDL-cholesterol) particles increased concurrently. Their clinical importance should be investigated in future.

摘要

背景

我们研究了急性甲状腺功能减退对无甲状腺患者血脂浓度的影响,尤其是对高密度脂蛋白(HDL-胆固醇)水平的影响。

材料与方法

31例有分化型甲状腺癌病史且接受了全甲状腺切除术、符合放射性碘治疗条件的患者纳入本研究。在甲状腺激素撤药前及撤药后2至6周测量他们的血脂谱和血清促甲状腺激素(TSH)水平。血脂浓度采用配对t检验进行比较,血清TSH采用Wilcoxon符号秩检验。P值<0.05被认为具有统计学意义。

结果

在甲状腺激素抑制治疗时TSH浓度中位数为0.06 mU/升,在甲状腺激素撤药阶段为102 mU/升(P<0.0001)。撤药后所有血脂的血清浓度均显著升高(P<0.0001)。HDL-胆固醇浓度的平均值(标准差)从44±9 mg/dL升至58±17 mg/dL。在急性甲状腺功能减退期间,总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和甘油三酯水平分别升高了58%、75%、30%和59%。

结论

本研究表明,甲状腺激素撤药在短时间内显著改变了血脂浓度。致动脉粥样硬化颗粒(低密度脂蛋白胆固醇)和心脏保护颗粒(高密度脂蛋白胆固醇)的水平同时升高。它们的临床重要性有待未来进一步研究。

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Thyroxine replacement therapy and circulating lipid concentrations.甲状腺素替代疗法与循环脂质浓度
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本文引用的文献

1
The effect of thyroid disorders on lipid levels and metabolism.甲状腺疾病对血脂水平和代谢的影响。
Med Clin North Am. 2012 Mar;96(2):269-81. doi: 10.1016/j.mcna.2012.01.012. Epub 2012 Feb 14.
8
Hypothyroidism and atherosclerosis.甲状腺功能减退与动脉粥样硬化。
J Clin Endocrinol Metab. 2003 Jun;88(6):2438-44. doi: 10.1210/jc.2003-030398.
9
Thyroid and lipid metabolism.甲状腺与脂质代谢。
Int J Obes Relat Metab Disord. 2000 Jun;24 Suppl 2:S109-12. doi: 10.1038/sj.ijo.0801292.

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