Karbownik-Lewińska Małgorzata, Stępniak Jan, Lewiński Andrzej
Department of Oncological Endocrinology, Medical University of Lodz, 90-752 Lodz, Poland.
Department of Endocrinology and Metabolic Diseases, Polish Mother's Memorial Hospital-Research Institute, 93-338 Lodz, Poland.
J Clin Med. 2021 Nov 18;10(22):5384. doi: 10.3390/jcm10225384.
Isolated hypothyroxinemia (IH) unfavorably affects reproduction. This study aimed to evaluate retrospectively if any routinely measured clinical/laboratory parameters are associated with IH among women of childbearing age hospitalized in the endocrine department. A group of 466 female non-pregnant inpatients (age range 13-57 years) was considered. IH (decreased free thyroxine (FT4) with normal TSH) was found in 8/466 patients (1.72%). Vitamin D deficiency (<30 ng/mL) was found in all patients with IH, whereas severe Vitamin D deficiency (<20 ng/mL) was found in 5/6. Vitamin D concentration was lower in IH females. FT4 concentration was lower in patients with severe vitamin D deficiency and correlated positively with vitamin D concentration. Insulin resistance index (IRI) was increased (>1.25) in 5/6 patients with IH. IRI was higher in IH patients and it was the only independent linear factor for IH in the univariate regression. FT4 concentration was lower in patients with increased IRI and correlated negatively with IRI. FT4 concentration correlated negatively with body mass index (BMI) and LDL cholesterol or triglycerides, and positively with HDL cholesterol or HDLC/cholesterol ratio. Vitamin D deficiency, insulin resistance and increased BMI (as potential causative factors), and abnormal lipid profile (as a possible consequence), are associated with IH in women of childbearing age. Eliminating risk factors for hypothyroxinemia may improve reproductive health.
单纯低甲状腺素血症（IH）对生殖产生不利影响。本研究旨在回顾性评估在内分泌科住院的育龄女性中，是否有任何常规测量的临床/实验室参数与IH相关。研究纳入了一组466名非妊娠女性住院患者（年龄范围13 - 57岁）。在466名患者中有8名（1.72%）被发现患有IH（促甲状腺激素（TSH）正常但游离甲状腺素（FT4）降低）。所有IH患者均存在维生素D缺乏（<30 ng/mL），而6名患者中有5名存在严重维生素D缺乏（<20 ng/mL）。IH女性的维生素D浓度较低。严重维生素D缺乏患者的FT4浓度较低，且与维生素D浓度呈正相关。6名IH患者中有5名胰岛素抵抗指数（IRI）升高（>1.25）。IH患者的IRI较高，且在单变量回归中是IH的唯一独立线性因素。IRI升高的患者FT4浓度较低，且与IRI呈负相关。FT4浓度与体重指数（BMI）、低密度脂蛋白胆固醇或甘油三酯呈负相关，与高密度脂蛋白胆固醇或高密度脂蛋白胆固醇/胆固醇比值呈正相关。维生素D缺乏、胰岛素抵抗和BMI升高（作为潜在病因）以及血脂异常（作为可能后果）与育龄女性的IH相关。消除低甲状腺素血症的危险因素可能会改善生殖健康。
