Song Xiaocheng, Zhu Yudan, Dai Zhi, Ling Guimei, Tang Hongqin, Xu Qiannan, Guo Tinglin
Department of Respiratory and Critical Care Medicine, Naval Hospital of Eastern Theater of PLA Zhoushan, Zhejiang Province, China.
Department of Critical Care Medicine, 921 Hospital of Joint Logistics Support Force of PLA Changsha, Hunan Province, China.
Am J Cardiovasc Dis. 2020 Dec 15;10(5):585-592. eCollection 2020.
Hypothyroidism is a disease with symptoms of collective metabolic dysfunction and systemic dysfunction due to the lack of serum thyroid hormones caused by various reasons. GLUT4 is over-expressed in monocytes of patients with hyperthyroidism, there are also studies suggesting that there is a certain regulatory relationship of GLUT1 and GLUT4 with thyroid function. This study is aimed to explore the correlation of glucose transporter 1 (GLUT1) and GLUT4 with prognosis of patients with hypothyroidism and cardiac insufficiency.
From July 2016 to October 2019, totally 116 patients with cardiac insufficiency complicated with subclinical hypothyroidism treated in our hospital were enrolled in the research group (RG), and 110 patients with cardiac insufficiency but normal thyroid function were enrolled in the control group (CG). Serum GLUT1, GLUT4, free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) were detected, and the correlation between them was analyzed. Then the predictive value and risk factors of GLUT1 and GLUT4 for poor prognosis of hypothyroidism complicated with cardiac insufficiency were analyzed.
The expression levels of GLUT1, GLUT4, FT3 and FT4 in serum of patients in RG was notably lower than that in CG, and TSH expression was remarkably higher than those in CG (P<0.05). In RG, GLUT1 and GLUT4 expression levels were positively correlated with FT3 and FT4 expression (P<0.05), but negatively correlated with TSH expression (P<0.05). ROC of GLUT1 and GLUT4 in RG in predicting poor prognosis of patients was over 0.8. Low expression of GLUT1 and GLUT4 and diabetes were independent risk factors for poor prognosis in patients with hypothyroidism complicated with cardiac insufficiency.
GLUT1 and GLUT4 expression levels were significantly decreased in serum of patients with hypothyroidism complicated with cardiac insufficiency. Both of them have high predictive value for poor prognosis of patients, and are independent risk factors for poor prognosis of patients.
甲状腺功能减退症是由于各种原因导致血清甲状腺激素缺乏而出现集体代谢功能障碍和全身功能障碍症状的疾病。葡萄糖转运蛋白4（GLUT4）在甲状腺功能亢进症患者的单核细胞中过度表达，也有研究表明葡萄糖转运蛋白1（GLUT1）和GLUT4与甲状腺功能存在一定的调节关系。本研究旨在探讨葡萄糖转运蛋白1（GLUT1）和GLUT4与甲状腺功能减退症合并心脏功能不全患者预后的相关性。
选取2016年7月至2019年10月在我院治疗的116例心脏功能不全合并亚临床甲状腺功能减退症患者作为研究组（RG），选取110例心脏功能不全但甲状腺功能正常的患者作为对照组（CG）。检测血清GLUT1、GLUT4、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）和促甲状腺激素（TSH），并分析它们之间的相关性。然后分析GLUT1和GLUT4对甲状腺功能减退症合并心脏功能不全患者预后不良的预测价值及危险因素。
研究组患者血清中GLUT1、GLUT4、FT3和FT4的表达水平明显低于对照组，TSH表达明显高于对照组（P<0.05）。在研究组中，GLUT1和GLUT4表达水平与FT3和FT4表达呈正相关（P<0.05），但与TSH表达呈负相关（P<0.05）。研究组中GLUT1和GLUT4预测患者预后不良的曲线下面积（ROC）均超过0.8。GLUT1和GLUT4低表达及糖尿病是甲状腺功能减退症合并心脏功能不全患者预后不良的独立危险因素。
甲状腺功能减退症合并心脏功能不全患者血清中GLUT1和GLUT4表达水平明显降低。它们对患者预后不良均具有较高的预测价值，且是患者预后不良的独立危险因素。
