Ozkan Cigdem, Akturk Mujde, Altinova Alev Eroglu, Cerit Ethem Turgay, Gulbahar Ozlem, Yalcin Mehmet Muhittin, Cakir Nuri, Balos Toruner Fusun
Gazi University Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey.
Endocr J. 2015;62(12):1091-9. doi: 10.1507/endocrj.EJ15-0308. Epub 2015 Oct 22.
The cardiovascular effects of short-term overt hypothyroidism are not well known. We investigated proprotein convertase subtilisin/kexin type 9 (PCSK9), soluble lectin-like oxidized LDL receptor 1 (sLOX-1) and the ankle brachial index (ABI) in thyroid cancer patients with short-term overt hypothyroidism due to thyroid hormone withdrawal (THW). Twenty-one patients requiring radioactive iodine (RAI) ablation or scanning and 36 healthy control subjects were enrolled. Patients were evaluated in the subclinical thyrotoxic phase when they were on suppressive levothyroxine therapy and in the overt hypothyroid phase due to THW for four weeks. PCSK9, sLOX-1, lipids and ABI were measured in the patient and control groups. Total cholesterol, LDL cholesterol, triglycerides and Apo B levels were increased in short overt hypothyroidism compared with the control group (p<0.001). PCSK9 levels increased before THW and after THW in the patients compared to control group (p<0.001, p=0.004, respectively). sLOX-1 levels were not different between patients with short term overt hypothyroidism and control group (p=0.27). ABI was found to be significantly decreased in patients with thyroid cancer before and after THW compared to control group (p=0.04, p=0.002 respectively). PCSK9 levels were correlated negatively with ABI (r=-0.38, p=0.004). In conclusion; our study demonstrated that patients with differentiated thyroid cancer both before and after THW which is a short term overt hypothyroid phase, had increased PCSK9 levels and decreased ABI. Short term overt hypothyroidism also leads to increased HDL, LDL, total cholesterol, Apo A and Apo B levels.
短期显性甲状腺功能减退对心血管系统的影响尚不明确。我们对因甲状腺激素撤药(THW)导致短期显性甲状腺功能减退的甲状腺癌患者的前蛋白转化酶枯草溶菌素/克新9型(PCSK9)、可溶性凝集素样氧化低密度脂蛋白受体1(sLOX-1)和踝臂指数(ABI)进行了研究。纳入了21例需要放射性碘(RAI)消融或扫描的患者以及36名健康对照者。在患者处于甲状腺素抑制治疗的亚临床甲状腺毒症期以及因THW导致的显性甲状腺功能减退期(为期四周)时进行评估。对患者组和对照组测定了PCSK9、sLOX-1、血脂和ABI。与对照组相比,短期显性甲状腺功能减退时总胆固醇、低密度脂蛋白胆固醇、甘油三酯和载脂蛋白B水平升高(p<0.001)。与对照组相比,患者在THW前和THW后的PCSK9水平均升高(分别为p<0.001,p=0.004)。短期显性甲状腺功能减退患者与对照组之间的sLOX-1水平无差异(p=0.27)。与对照组相比,甲状腺癌患者在THW前后的ABI均显著降低(分别为p=0.04,p=0.002)。PCSK9水平与ABI呈负相关(r=-0.38,p=0.004)。总之,我们的研究表明,在短期显性甲状腺功能减退期的THW前后,分化型甲状腺癌患者的PCSK9水平升高且ABI降低。短期显性甲状腺功能减退还会导致高密度脂蛋白、低密度脂蛋白、总胆固醇、载脂蛋白A和载脂蛋白B水平升高。