Sun Xianglan, Sun Ying, Li Wan-Chun, Chen Chang-Yi, Chiu Yen-Hui, Chien Hung-Yu, Wang Yao
Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, China.
Intern Med. 2015;54(20):2537-44. doi: 10.2169/internalmedicine.54.4514. Epub 2015 Oct 15.
Thyroid hormone plays an important role in regulating the lipid and glucose metabolism. Previously, much attention has been drawn to define the pathophysiological relationship between thyroid dysfunction and the incidence of cardiovascular diseases (CVDs). While the conditions of overt hypothyroidism and subclinical hypothyroidism were both emphasized, the association between CVD risks and the deregulated circulating thyroid-stimulating hormone (TSH) level remains to be elucidated. Nevertheless, multiple TSH-mediated physiological adaptations, including alteration of the serum lipids, body mass index, blood pressure and insulin sensitivity, have led to the difficulty of clearly examining the association between the TSH level and CVD prevalence. The current review aims to 1) summarize the evidence for the role of thyroid dysfunction and TSH abnormality in CVD pathogenesis and 2) explore the possible underlying molecular mechanisms of TSH-mediated cardiovascular pathology in hopes of providing better therapeutic strategies for the patients with deregulated TSH.
甲状腺激素在调节脂质和葡萄糖代谢中起重要作用。此前，人们对明确甲状腺功能障碍与心血管疾病（CVD）发病率之间的病理生理关系给予了极大关注。虽然明显甲状腺功能减退和亚临床甲状腺功能减退的情况都受到了重视，但CVD风险与循环甲状腺刺激激素（TSH）水平失调之间的关联仍有待阐明。然而，多种TSH介导的生理适应性变化，包括血清脂质、体重指数、血压和胰岛素敏感性的改变，使得难以清晰地研究TSH水平与CVD患病率之间的关联。本综述旨在1）总结甲状腺功能障碍和TSH异常在CVD发病机制中的作用证据，2）探索TSH介导的心血管病理潜在分子机制，以期为TSH失调的患者提供更好的治疗策略。
