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显性甲状腺功能减退症患者身体成分变化、心外膜脂肪组织及血清网膜素-1水平的评估

Evaluation of body composition changes, epicardial adipose tissue, and serum omentin-1 levels in overt hypothyroidism.

作者信息

Cerit Ethem Turgay, Akturk Mujde, Altinova Alev E, Tavil Yusuf, Ozkan Cigdem, Yayla Cagri, Altay Mustafa, Demirtas Canan, Cakir Nuri

机构信息

Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, 06500, Ankara, Turkey,

出版信息

Endocrine. 2015 May;49(1):196-203. doi: 10.1007/s12020-014-0460-2. Epub 2014 Oct 25.

Abstract

Our aim was to investigate body composition changes, epicardial adipose tissue thickness (EATT), serum omentin-1 levels, and the relationship among them along with some atherosclerosis markers in overt hypothyroidism. Twenty-eight newly diagnosed overt hypothyroid patients were evaluated before and after 6 months of thyroid hormone replacement therapy (THRT) and compared to the healthy subjects in this prospective longitudinal study. Body compositions were measured with dual-energy X-ray absorptiometry, and EATT was measured by echocardiography. Carotid intima-media thickness (c-IMT), flow-mediated dilatation (FMD), thyroid hormone levels, lipid parameters, high sensitive c-reactive protein, homocysteine, and omentin-1 levels were measured in all subjects. Body weight and lean body mass were higher in patients with hypothyroidism compared to euthyroid state after THRT (p = 0.012, 0.034, respectively). EATT was higher in patients with hypothyroidism than the control group (p < 0.001) and decreased with THRT (p = 0.012) but still remained higher than the control group (p < 0.001). Free T4 levels were found to be an independent factor to predict EATT (p < 0.001). In hypothyroid state, omentin-1 levels were lower than controls (p = 0.037) but increased in 6 months with THRT (p = 0.001). The c-IMT was higher, and FMD was lower in hypothyroidism compared to euthyroid state and control group (p < 0.05). Increasing lean body mass, but not adipose tissue mass, was found to be responsible for weight gain in hypothyroidism. The increased amount of EATT and decreased omentin-1 levels can contribute to the development of atherosclerosis in addition to other factors in hypothyroidism.

摘要

我们的目的是研究显性甲状腺功能减退症患者的身体成分变化、心外膜脂肪组织厚度(EATT)、血清网膜素-1水平及其相互关系,以及一些动脉粥样硬化标志物。在这项前瞻性纵向研究中,对28例新诊断的显性甲状腺功能减退症患者在接受甲状腺激素替代治疗(THRT)6个月前后进行评估,并与健康受试者进行比较。采用双能X线吸收法测量身体成分,通过超声心动图测量EATT。测量所有受试者的颈动脉内膜中层厚度(c-IMT)、血流介导的血管舒张功能(FMD)、甲状腺激素水平、血脂参数、高敏c反应蛋白、同型半胱氨酸和网膜素-1水平。与THRT后甲状腺功能正常状态相比,甲状腺功能减退症患者的体重和去脂体重更高(分别为p = 0.012、0.034)。甲状腺功能减退症患者的EATT高于对照组(p < 0.001),THRT后降低(p = 0.012),但仍高于对照组(p < 0.001)。发现游离T4水平是预测EATT的独立因素(p < 0.001)。在甲状腺功能减退状态下,网膜素-1水平低于对照组(p = 0.037),但THRT 6个月后升高(p = 0.001)。与甲状腺功能正常状态和对照组相比,甲状腺功能减退症患者的c-IMT更高,FMD更低(p < 0.05)。发现去脂体重增加而非脂肪组织质量增加是甲状腺功能减退症患者体重增加的原因。除甲状腺功能减退症中的其他因素外,EATT增加和网膜素-1水平降低可促进动脉粥样硬化的发展。

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