Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing 100730, China.
Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing 100730, China.
Clin Chim Acta. 2020 Jul;506:122-128. doi: 10.1016/j.cca.2020.03.012. Epub 2020 Mar 9.
Thyroid stimulating hormone (TSH) is associated with lipid metabolism. In this study, we aimed to evaluate seasonal variations and the association between TSH and lipid profiles based on clinical big data.
This observational, retrospective big data study enrolled a total of 20,192 individuals who visited Peking Union Medical College Hospital for routine health check-ups from 2014 to 2018. Demographic, medical history, common biochemical analytes, and thyroid related test data were obtained. A Kruskal-wallis analysis was used to compare the differences in total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) by TSH quartiles. Spearman correlation analysis was used to evaluate the association between TSH and lipid profiles as well as temperature.
TC and LDL did not vary significantly with TSH concentration; however, TG and HDL-C did. TSH concentration showed weak positive correlation with serum TC, TG, and HDL-C but not with LDL-C. Serum TC concentration was positively correlated with TG and LDL-C. TG was positively correlated with LDL-C but negatively correlated with HDL-C. HDL-C was negatively correlated with LDL-C. TSH and lipid profiles showed seasonal fluctuations. Monthly median TSH, TC, and LDL-C peaked in winter and dropped to a minimum in summer. The correlation coefficient (r) between the average monthly temperature and TSH, TC, TG, HDL-C, and LDL-C was -0.424 (p = 0.001), -0.539 (p < 0.001), -0.020 (p = 0.880), -0.199 (p = 0.127), and -0.442 (p < 0.001), respectively.
Seasonal variation was observed in both TSH and lipids. Apart from the seasonal variation of TC and LDL-C, our results also have clinical interpretation. It suggested that it may not reflect the real status of lipids during and immediately after the Spring festival. Thus, in order to diagnosis of hypercholesterolemia, re-testing was needed later to provide the precision diagnostic, monitoring and treatment.
促甲状腺激素（TSH）与脂质代谢有关。本研究旨在基于临床大数据评估 TSH 的季节性变化及其与血脂谱之间的关联。
这是一项观察性、回顾性的大数据研究，共纳入 2014 年至 2018 年期间到北京协和医院进行常规健康检查的 20192 名个体。获取人口统计学、病史、常见生化指标和甲状腺相关检查数据。采用 Kruskal-Wallis 分析比较 TSH 四分位数组之间总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）的差异。Spearman 相关分析用于评估 TSH 与血脂谱以及温度之间的相关性。
TC 和 LDL-C 与 TSH 浓度无显著差异；然而，TG 和 HDL-C 则存在差异。TSH 浓度与血清 TC、TG 和 HDL-C 呈弱正相关，但与 LDL-C 无关。血清 TC 浓度与 TG 和 LDL-C 呈正相关，TG 与 LDL-C 呈正相关，与 HDL-C 呈负相关，HDL-C 与 LDL-C 呈负相关。TSH 和血脂谱存在季节性波动。每月中位数 TSH、TC 和 LDL-C 于冬季达到峰值，夏季降至最低。平均每月温度与 TSH、TC、TG、HDL-C 和 LDL-C 的相关系数（r）分别为-0.424（p=0.001）、-0.539（p<0.001）、-0.020（p=0.880）、-0.199（p=0.127）和-0.442（p<0.001）。
TSH 和脂质均存在季节性变化。除了 TC 和 LDL-C 的季节性变化外，我们的结果还有临床解释意义。这表明，春节期间和之后，血脂的真实情况可能无法反映出来。因此，为了诊断高胆固醇血症，需要在之后进行重新检测，以提供更精准的诊断、监测和治疗。
