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他汀类药物是否会影响碘轻度至中度缺乏地区高脂血症患者的甲状腺体积和结节大小?一项前瞻性研究。

Do Statins Affect Thyroid Volume and Nodule Size in Patients with Hyperlipidemia in a Region with Mild-to-Moderate Iodine Deficiency? A Prospective Study.

机构信息

Department of Endocrinology and Metabolism, Baskent University School of Medicine, Ankara, Turkey.

Department Family Medicine, Baskent University School of Medicine, Ankara, Turkey.

出版信息

Med Princ Pract. 2018;27(1):1-7. doi: 10.1159/000486748. Epub 2018 Jan 23.

Abstract

OBJECTIVE

The objective of this study was to assess the antiproliferative pleiotropic effects of statins on thyroid function, volume, and nodularity.

SUBJECTS AND METHODS

One hundred and six hyperlipidemic patients were included in this prospective study. The 69 patients in the statin groups received atorvastatin (16 received 10 mg and 18 received 20 mg) or rosuvastatin (20 received 10 mg and 15 received 20 mg). The 37 patients in the control group, assessed as not requiring drugs, made only lifestyle changes. Upon admission and after 6 months, all patients were evaluated by ultrasonography as well as for lipid variables (total cholesterol, high- and low-density lipoprotein cholesterol, and triglycerides) and thyroid function and structure.

RESULTS

After 6 months, no differences in thyroid function, thyroid volume, the number of thyroid nodules, or nodule size were observed in the statin and control groups. In a subgroup analysis, total thyroid volume had decreased more in patients receiving 20 mg of rosuvastatin than that in the control group (p < 0.05). Maximum nodule size had decreased more in those receiving 10 mg of rosuvastatin (p < 0.05).

CONCLUSIONS

Our results suggest an association between rosuvastatin treatment and smaller thyroid volume and maximum nodule diameter; this could be attributable to the antiproliferative effects of statin therapy on the thyroid.

摘要

目的

本研究旨在评估他汀类药物对甲状腺功能、体积和结节性的抗增殖多效性作用。

方法

本前瞻性研究纳入了 106 例高脂血症患者。他汀组 69 例患者接受阿托伐他汀(16 例接受 10mg,18 例接受 20mg)或瑞舒伐他汀(20 例接受 10mg,15 例接受 20mg)治疗。37 例对照组患者评估后认为无需药物治疗,仅进行生活方式改变。所有患者在入院时和 6 个月后均通过超声检查以及血脂变量(总胆固醇、高低密度脂蛋白胆固醇和甘油三酯)和甲状腺功能及结构进行评估。

结果

6 个月后,他汀组和对照组的甲状腺功能、甲状腺体积、甲状腺结节数量或结节大小均无差异。亚组分析显示,接受 20mg 瑞舒伐他汀治疗的患者总甲状腺体积较对照组下降更多(p<0.05)。接受 10mg 瑞舒伐他汀治疗的患者最大结节直径下降更多(p<0.05)。

结论

我们的结果提示瑞舒伐他汀治疗与甲状腺体积和最大结节直径减小之间存在关联;这可能归因于他汀类药物治疗对甲状腺的抗增殖作用。

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