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亚临床甲状腺功能减退症患者血浆的高致动脉粥样硬化指数:对心血管疾病风险评估的意义。

High atherogenic index of plasma in subclinical hypothyroidism: Implications in assessment of cardiovascular disease risk.

作者信息

James Stephen R, Ray Lopamudra, Ravichandran Kandasamy, Nanda Sunil Kumar

机构信息

Department of Biochemistry, Pondicherry Institute of Medical Sciences, Puducherry, India.

Department of Biostatistics, Pondicherry Institute of Medical Sciences, Puducherry, India.

出版信息

Indian J Endocrinol Metab. 2016 Sep-Oct;20(5):656-661. doi: 10.4103/2230-8210.190550.

Abstract

BACKGROUND

A controversy exists regarding the association between subclinical hypothyroidism (SH) and dyslipidemia. Moreover, studies on lipid ratios and atherogenic index of plasma (AIP) in SH are rare, particularly in the Indian scenario.

AIM

This study aimed to investigate abnormalities in conventional lipid profile, lipid ratios, and AIP in SH and attempted to correlate thyroid stimulating hormone (TSH) and AIP in SH.

MATERIALS AND METHODS

In this retrospective analysis of patient records of SH subjects and euthyroid subjects, age, free triiodothyronine, free thyroxine, TSH, total cholesterol, triglycerides, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol, lipid ratios, and AIP were compared between the two groups. The correlation of TSH and AIP in SH was studied. Spearman's correlation, Mann-Whitney U-test and logistic regression analysis were performed.

RESULTS

Triglyceride, triglyceride/HDL-C, and AIP were significantly higher in SH as compared to euthyroid group, but there was no correlation between TSH and AIP in SH. AIP emerged as the significant single factor associated with SH in multiple logistic regressions.

CONCLUSION

The positive association of dyslipidemia and SH indicates a need for regular screening of these patients to enable early diagnosis and treatment of dyslipidemia. Even in patients who have a normal conventional lipid profile, lipid ratios, and AIP have to be calculated for better assessment of atherogenic risk.

摘要

背景

亚临床甲状腺功能减退(SH)与血脂异常之间的关联存在争议。此外,关于SH患者的血脂比值和血浆致动脉粥样硬化指数(AIP)的研究很少,尤其是在印度的情况。

目的

本研究旨在调查SH患者常规血脂谱、血脂比值和AIP的异常情况,并试图将SH患者的促甲状腺激素(TSH)与AIP进行关联分析。

材料与方法

在对SH患者和甲状腺功能正常患者的病历进行回顾性分析时,比较了两组患者的年龄、游离三碘甲状腺原氨酸、游离甲状腺素、TSH、总胆固醇、甘油三酯、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇、血脂比值和AIP。研究了SH患者中TSH与AIP的相关性。进行了Spearman相关性分析、Mann-Whitney U检验和逻辑回归分析。

结果

与甲状腺功能正常组相比,SH患者的甘油三酯、甘油三酯/HDL-C和AIP显著更高,但SH患者中TSH与AIP之间无相关性。在多元逻辑回归中,AIP是与SH相关的显著单一因素。

结论

血脂异常与SH的正相关表明需要对这些患者进行定期筛查,以便早期诊断和治疗血脂异常。即使对于常规血脂谱正常的患者,也必须计算血脂比值和AIP,以更好地评估动脉粥样硬化风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db2b/5040046/9a6476c6fa83/IJEM-20-656-g004.jpg

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