重组人促甲状腺素对脂质的影响。
Effect of rhTSH on Lipids.
作者信息
Delitala Alessandro P, Scuteri Angelo, Maioli Margherita, Casu Gavino, Merella Pierluigi, Fanciulli Giuseppe
机构信息
U.O.C. Medicina Interna 2, Azienda Ospedaliero-Universitaria di Sassari, 07100 Sassari, Italy.
Department of Surgical, Medical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy.
出版信息
J Clin Med. 2020 Feb 14;9(2):515. doi: 10.3390/jcm9020515.
BACKGROUND
Subclinical hypothyroidism is associated with increased blood lipid levels. However, the exact role of thyrotropin (TSH) alone is not clear. In order to clarify this point, we analysed the acute effect of recombinant human TSH (rhTSH) administration on lipid levels.
METHODS
Sera of 27 premenopausal women with well-differentiated thyroid cancer were analysed. Patients that underwent a total thyroidectomy, ablation with I (Iodine 131) and rhTSH administration as a part of routine follow-up American Thyroid Association guidelines were included. The protocol consists of 2 intramuscular injections of 0.9 mg of rhTSH, performed on day 1 day and day 2, with blood collection on day 1 (before rhTSH administration), and day 5. TSH, free thyroxine, total cholesterol, low-density lipoprotein cholesterol (LDLc), high density lipoprotein cholesterol (HDLc), and triglycerides were assessed in all the samples, before and four days after the first administration of rhTSH.
RESULTS
Total cholesterol and triglycerides significantly increased after stimulation of rhTSH (respectively, 192 ± 33 vs. 207 ± 26, = 0.036 and 72 ± 23 vs. 85 ± 23, = 0.016). LDLc and HDLc showed comparable concentrations before and after the test (respectively, 115 ± 27 vs. 126 ± 22, = 0.066, and 62 ± 15 vs. 64 ± 15, = 0.339), while non-HDLc increased after stimulation (130 ± 30 vs. 143 ± 25, = 0.045).
CONCLUSION
TSH has a direct effect on total cholesterol, triglycerides, and nonHDLc. Explanation of these phenomena will require additional studies.
背景
亚临床甲状腺功能减退与血脂水平升高有关。然而，单独促甲状腺激素（TSH）的确切作用尚不清楚。为了阐明这一点，我们分析了重组人促甲状腺激素（rhTSH）给药对血脂水平的急性影响。
方法
对27例绝经前分化型甲状腺癌女性的血清进行分析。纳入按照美国甲状腺协会指南作为常规随访一部分接受全甲状腺切除术、碘131消融及rhTSH给药的患者。方案包括在第1天和第2天进行2次肌肉注射，每次0.9mg rhTSH，并在第1天（rhTSH给药前）和第5天采血。在首次给予rhTSH之前和之后4天，对所有样本中的TSH、游离甲状腺素、总胆固醇、低密度脂蛋白胆固醇（LDLc）、高密度脂蛋白胆固醇（HDLc）和甘油三酯进行评估。
结果
rhTSH刺激后总胆固醇和甘油三酯显著升高（分别为192±33对207±26，P = 0.036；72±23对85±23，P = 0.016）。LDLc和HDLc在测试前后浓度相当（分别为115±27对126±22，P = 0.066；62±15对64±15，P = 0.339），而非HDLc在刺激后升高（130±30对143±25，P = 0.045）。
结论
TSH对总胆固醇、甘油三酯和非HDLc有直接影响。对这些现象的解释需要进一步研究。
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