Salehidoost Rezvan, Aminorroaya Ashraf, Iraj Bijan, Amini Massoud
Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2012 Aug;17(8):724-7.
We investigated the effect of acute hypothyroidism on lipid concentrations especially on high density lipoprotein (HDL-cholesterol) level in athyroatic patients.
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.
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.
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.
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。
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。
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%。
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。