Department of Pharmacology, Faculty of Medicine, Assiut University, Assiut, Egypt.
Department of Dermatology and Andrology, Al-Azhar University, Assuit, Egypt.
Clin Exp Pharmacol Physiol. 2021 Oct;48(10):1317-1326. doi: 10.1111/1440-1681.13552. Epub 2021 Jul 29.
Although oral isotretinoin has been widely used as a basic treatment of acne in adolescents, several studies have noted some alterations in thyroid functions during oral isotretinoin therapy. Therefore, the present study aims at evaluating the possible changes in thyroid-stimulating hormone (TSH), free thyroxin (fT4) and free triiodothyronine (fT3) levels during isotretinoin treatment and analyzing the possible factors which may contribute to such changes. In the present study, 47 patients received (0.5 mg/kg oral isotretinoin) for treatment of severe acne. TSH, fT4 and fT3 were measured at baseline, after 3 and 6 months. ANOVA tests were used for statistical analyses. The levels of fT4 and fT3 decreased significantly during isotretinoin treatment (from 0.85 ± 0.04 and 3.1 ± 0.26 at baseline to 0.81 ± 0.023 and 2.76 ± 0.2 after 6 months, respectively). The decrease was accompanied by significant elevation of TSH (0.66 ± 0.05 at baseline to 0.695 ± 0.05 after 6 months). The duration of therapy (but not the dose) has significantly affected all the hormonal changes. Previous incomplete or intermittent isotretinoin treatment had significantly influenced the changes in fT4 only, while gender affected the changes of TSH. Isotretinoin treatment can decrease fT4, fT3 and increase TSH. The pattern of these changes was affected by gender and previous isotretinoin therapy. Different doses of isotretinoin did not affect the hormonal changes, but the duration has been the major influencing factor.
虽然口服异维 A 酸已被广泛用于青少年痤疮的基本治疗，但几项研究指出，在口服异维 A 酸治疗期间，甲状腺功能会发生一些变化。因此，本研究旨在评估异维 A 酸治疗期间促甲状腺激素（TSH）、游离甲状腺素（fT4）和游离三碘甲状腺原氨酸（fT3）水平可能发生的变化，并分析可能导致这些变化的因素。本研究中，47 例患者接受（0.5mg/kg 口服异维 A 酸）治疗严重痤疮。在基线、治疗 3 个月和 6 个月时测量 TSH、fT4 和 fT3。采用 ANOVA 检验进行统计学分析。在异维 A 酸治疗期间，fT4 和 fT3 的水平显著下降（从基线时的 0.85±0.04 和 3.1±0.26 降至 6 个月时的 0.81±0.023 和 2.76±0.2）。这种下降伴随着 TSH 的显著升高（从基线时的 0.66±0.05 升至 6 个月时的 0.695±0.05）。治疗持续时间（而非剂量）显著影响了所有的激素变化。以前的不完全或间歇性异维 A 酸治疗显著影响了 fT4 的变化，而性别则影响了 TSH 的变化。异维 A 酸治疗可降低 fT4、fT3 并增加 TSH。这些变化的模式受性别和以前异维 A 酸治疗的影响。异维 A 酸的不同剂量不会影响激素变化，但治疗时间是主要影响因素。
