亚临床甲状腺功能减退患者的心外膜脂肪组织厚度及其与内脏脂肪组织厚度的关系。
Epicardial Adipose Tissue Thickness in Patients With Subclinical Hypothyroidism and the Relationship Thereof With Visceral Adipose Tissue Thickness.
作者信息
Arpaci Dilek, Gurkan Tocoglu Aysel, Yilmaz Sabiye, Korkmaz Sumeyye, Ergenc Hasan, Gunduz Huseyin, Keser Nurgul, Tamer Ali
机构信息
Department of Endocrinology and Metabolism, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey.
Department of Internal Medicine, Faculty of Medicine, Sakarya University, Sakarya, Turkey.
出版信息
J Clin Med Res. 2016 Mar;8(3):215-9. doi: 10.14740/jocmr2460w. Epub 2016 Jan 26.
BACKGROUND
Subclinical hypothyroidism (SH) is associated with cardiovascular metabolic syndromes, especially dislipidemia and abdominal obesity. Visceral abdominal adipose tissue (VAAT) and epicardial adipose tissue (EAT) have the same ontogenic origin and produce many proinflammatory and proatherogenic cytokines. We evaluated EAT and VAAT thickness in patients with SH.
METHODS
Forty-one patients with SH and 35 controls were included in the study. Demographical and anthropometric features of both patients and controls were recorded. Thyroid and metabolic parameters were measured. EAT was measured using 2D-transthoracic echocardiography.
RESULTS
The age and gender distributions were similar in the two groups (P = 0.998 and P = 0.121, respectively). Body mass index (BMI), fat mass, waist circumference (WC), hip circumference (HC), the WC/HC ratio, and the thicknesses of VAAT and abdominal subcutaneous adipose tissue were higher in the case group than the control group (all P values < 0.01). However, both groups had similar EAT thickness (P = 0.532), which was positively correlated with BMI, fat mass, WC, HC, VAAT thickness, abdominal subcutaneous adipose tissue thickness, and serum triglyceride (TG) level (all P values < 0.01). We found no correlation between EAT thickness and thyroid-stimulating hormone (TSH) level, free thyroxine (FT4) level, or low-density lipoprotein-cholesterol (LDL-C) level, and anti-TPO level (all P values > 0.05). We found no difference between the two groups in fasting plasma glucose (FPG) level (P = 0.780), but the levels of LDL-C and TG differed significantly (P = 0.002 and P = 0.026, respectively). The serum TSH level was higher and the FT4 level was lower in the case than the control group (both P values <0.01).
CONCLUSION
Increased abdominal adipose tissue thickness in patients with SH is associated with atherosclerosis. To detemine the risk of atherosclerosis in such patients, EAT measurements are valuable; such assessment is simple to perform.
背景
亚临床甲状腺功能减退（SH）与心血管代谢综合征相关，尤其是血脂异常和腹型肥胖。内脏腹部脂肪组织（VAAT）和心外膜脂肪组织（EAT）具有相同的起源，并产生许多促炎和促动脉粥样硬化细胞因子。我们评估了SH患者的EAT和VAAT厚度。
方法
本研究纳入了41例SH患者和35例对照。记录了患者和对照的人口统计学和人体测量学特征。测量了甲状腺和代谢参数。使用二维经胸超声心动图测量EAT。
结果
两组的年龄和性别分布相似（分别为P = 0.998和P = 0.121）。病例组的体重指数（BMI）、脂肪量、腰围（WC）、臀围（HC）、WC/HC比值以及VAAT和腹部皮下脂肪组织的厚度均高于对照组（所有P值<0.01）。然而，两组的EAT厚度相似（P = 0.532），其与BMI、脂肪量、WC、HC、VAAT厚度、腹部皮下脂肪组织厚度和血清甘油三酯（TG）水平呈正相关（所有P值<0.01）。我们发现EAT厚度与促甲状腺激素（TSH）水平、游离甲状腺素（FT4）水平、低密度脂蛋白胆固醇（LDL-C）水平或抗甲状腺过氧化物酶（anti-TPO）水平之间无相关性（所有P值>0.05）。两组的空腹血糖（FPG）水平无差异（P = 0.780），但LDL-C和TG水平有显著差异（分别为P = 0.002和P = 0.026）。病例组的血清TSH水平高于对照组，FT4水平低于对照组（两者P值均<0.01）。
结论
SH患者腹部脂肪组织厚度增加与动脉粥样硬化相关。为了确定此类患者的动脉粥样硬化风险，测量EAT很有价值；这种评估操作简单。
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