Krysiak Robert, Szkróbka Witold, Okopień Bogusław
Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
Pharmacol Rep. 2016 Dec;68(6):1115-1119. doi: 10.1016/j.pharep.2016.07.002. Epub 2016 Jul 16.
Metformin was found to reduce elevated serum thyrotropin levels. No previous study has compared the effect of this drug on serum levels of thyrotropin and thyroid hormones between men and women.
The study included 23 women and 12 men with subclinical hypothyroidism, who because of coexisting diabetes or impaired fasting glucose were treated with metformin (1.7-3.0g daily). Fasting plasma glucose levels, the homeostatic model assessment 1 of insulin resistance ratio (HOMA1-IR), glycated hemoglobin, serum levels of thyrotropin, free and total thyroid hormones and prolactin, as well as thyroid peroxidase and thyroglobulin antibodies were assessed at baseline and after 4 months of metformin treatment.
Baseline serum levels of thyrotropin, free thyroxine and free triiodothyronine, as well as a percentage of patients with positive thyroid peroxidase and thyroglobulin antibodies were comparable in both sexes. Metformin treatment reduced plasma glucose and insulin resistance, irrespective of the gender. However, only in women, metformin decreased serum thyrotropin levels. Neither in men nor in women, metformin affected serum levels of thyroid hormone and prolactin, as well as in the subgroups of patients with thyroiditis thyroid antibody titers.
The obtained results suggest that sex may determine the effect of metformin on hypothalamic-pituitary-thyroid axis activity.
已发现二甲双胍可降低血清促甲状腺激素水平升高。此前尚无研究比较该药物对男性和女性血清促甲状腺激素及甲状腺激素水平的影响。
该研究纳入了23名女性和12名男性亚临床甲状腺功能减退患者，这些患者因合并糖尿病或空腹血糖受损而接受二甲双胍治疗（每日1.7 - 3.0克）。在基线时以及二甲双胍治疗4个月后，评估空腹血糖水平、胰岛素抵抗稳态模型评估1比值（HOMA1 - IR）、糖化血红蛋白、血清促甲状腺激素水平、游离和总甲状腺激素及催乳素水平，以及甲状腺过氧化物酶和甲状腺球蛋白抗体。
两性的基线血清促甲状腺激素、游离甲状腺素和游离三碘甲状腺原氨酸水平，以及甲状腺过氧化物酶和甲状腺球蛋白抗体阳性患者的百分比相当。二甲双胍治疗可降低血糖和胰岛素抵抗，与性别无关。然而，仅在女性中，二甲双胍降低了血清促甲状腺激素水平。在男性和女性中，二甲双胍均未影响血清甲状腺激素和催乳素水平，以及甲状腺炎患者亚组中的甲状腺抗体滴度。
所得结果表明，性别可能决定二甲双胍对下丘脑 - 垂体 - 甲状腺轴活性的影响。
