Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
Endocrinol Metab (Seoul). 2015 Sep;30(3):318-25. doi: 10.3803/EnM.2015.30.3.318. Epub 2015 May 18.
Thyroid hormones can influence energy metabolism and insulin sensitivity via their interaction with adipocytokines and gut hormones. The aims of this study were to evaluate differences in serum ghrelin and leptin concentrations according to thyroid hormone levels, and to investigate the correlation of insulin resistance.
A total of 154 patients (57 hyperthyroid patients, 61 euthyroid patients, and 36 hypothyroid patients; mean age, 47.9 years) were enrolled. Serum leptin, ghrelin, and insulin levels were measured and insulin resistance was calculated using the formula of the homeostasis model assessment of insulin resistance (HOMA-IR).
There were no differences in mean concentrations of ghrelin or leptin among the three groups. There were no significant differences in insulin levels between the groups (P=0.06), although hyperthyroid patients had borderline statistically significantly higher levels of insulin than did euthyroid subjects by post hoc test (26.4 μIU/mL vs. 16.1 μIU/mL, P=0.057). Regarding HOMA-IR index, the mean levels were highest in the hyperthyroid group among those of the three groups (hyperthyroid vs. euthyroid vs. hypothyroid, 6.7 vs. 3.8 vs. 4.4, P=0.068). Plasma levels of ghrelin were significantly negatively correlated with age, insulin, glucose, body mass index (BMI), and HOMA-IR. Plasma levels of leptin showed significant positive correlation with BMI and triglyceride. There were no significant correlations among thyroid hormone, thyrotropin, ghrelin, leptin, or insulin.
The present study found that serum ghrelin, leptin, and insulin levels didn't differ according to thyroid function conditions. Further studies with larger numbers of patients are required to establish a direct relationship between plasma ghrelin, leptin, and thyroid hormone.
甲状腺激素可通过与脂肪细胞因子和肠道激素相互作用来影响能量代谢和胰岛素敏感性。本研究旨在评估血清胃饥饿素和瘦素浓度根据甲状腺激素水平的差异,并探讨胰岛素抵抗的相关性。
共纳入 154 例患者(57 例甲状腺功能亢进患者,61 例甲状腺功能正常患者,36 例甲状腺功能减退患者;平均年龄 47.9 岁)。测量血清瘦素、胃饥饿素和胰岛素水平,并采用稳态模型评估胰岛素抵抗(HOMA-IR)公式计算胰岛素抵抗。
三组患者的胃饥饿素或瘦素平均浓度无差异。各组间胰岛素水平无显著差异(P=0.06),尽管事后检验显示甲状腺功能亢进患者的胰岛素水平略高于甲状腺功能正常患者(26.4μIU/mL 比 16.1μIU/mL,P=0.057)。关于 HOMA-IR 指数,三组中甲状腺功能亢进组的平均值最高(甲状腺功能亢进组比甲状腺功能正常组比甲状腺功能减退组,6.7 比 3.8 比 4.4,P=0.068)。血浆胃饥饿素水平与年龄、胰岛素、血糖、体重指数(BMI)和 HOMA-IR 呈显著负相关。血浆瘦素水平与 BMI 和甘油三酯呈显著正相关。甲状腺激素、促甲状腺激素、胃饥饿素、瘦素或胰岛素之间无显著相关性。
本研究发现血清胃饥饿素、瘦素和胰岛素水平与甲状腺功能状态无关。需要更多患者的进一步研究来建立血浆胃饥饿素、瘦素和甲状腺激素之间的直接关系。