Department of Endocrinology, Bielański Hospital, Centre of Postgraduate Medical Education, Warsaw, Poland.
Front Endocrinol (Lausanne). 2022 Jul 14;13:900034. doi: 10.3389/fendo.2022.900034. eCollection 2022.
FGF21 pharmacological treatment reverses fatty liver and lowers serum triglyceride concentration but FGF21 serum level is increased in hepatic steatosis. FGF21 secretion is induced by thyroid hormones .
To determine the influence of thyroid hormones and metabolic changes secondary to thyroid dysfunction on FGF21 secretion in humans.
This was a case-control study. 82 hyperthyroid and 15 hypothyroid patients were recruited together with 25 healthy controls. Of those with hyperthyroidism, 56 received radioiodine treatment and 42 of them achieved hypothyroidism and then euthyroidism within one year following therapy. Radioiodine-induced hypothyroidism developed abruptly within a six week interval between clinic visits. FGF21 serum levels were determined with an ELISA method.
Serum FGF21 levels did not differ in hyper- and hypothyroid patients in comparison to controls [median 103.25 (interquartile range, 60.90-189.48) and 86.10 (54.05-251.02) vs 85.20 (58.00-116.80) pg/mL P=0.200 and 0.503, respectively]. In hyperthyroid patients treated with radioiodine, serum FGF21 levels increased significantly in rapid-onset hypothyroidism in comparison to the hyperthyroid and euthyroid phase [median 160.55 (interquartile range, 92.48 - 259.35) vs 119.55 (67.78-192.32) and 104.43 (55.93-231.93) pg/mL, P=0.034 and 0.033, respectively]. The rising serum FGF21 level correlated positively with serum triglycerides (Spearman coefficient rs=0.36, P=0.017) and inversely with serum SHBG (rs=-0.41, P=0.007), but did not correlate with thyroid hormone levels.
There was a transient increase in FGF21 serum level during rapid-onset hypothyroidism following radioiodine treatment. There was no association between FGF21 serum level and thyroid hormones. In radioiodine-induced hypothyroidism, the rising serum FGF21 concentration correlated positively with rising serum triglycerides and negatively with falling SHBG, reflecting increased hepatic lipogenesis.
FGF21 药理学治疗可逆转脂肪肝并降低血清甘油三酯浓度，但在肝脂肪变性中 FGF21 血清水平升高。甲状腺激素诱导 FGF21 的分泌。
确定甲状腺激素和甲状腺功能障碍引起的代谢变化对人类 FGF21 分泌的影响。
这是一项病例对照研究。招募了 82 例甲状腺功能亢进症患者和 15 例甲状腺功能减退症患者，以及 25 名健康对照者。在甲状腺功能亢进症患者中，56 例接受放射性碘治疗，其中 42 例在治疗后一年内出现甲状腺功能减退症并随后恢复甲状腺功能正常。放射性碘诱导的甲状腺功能减退症在就诊间隔的六周内突然发生。使用 ELISA 法测定 FGF21 血清水平。
与对照组相比，甲状腺功能亢进症和甲状腺功能减退症患者的血清 FGF21 水平没有差异[中位数分别为 103.25（四分位距，60.90-189.48）和 86.10（54.05-251.02）与 85.20（58.00-116.80）pg/mL，P=0.200 和 0.503]。在接受放射性碘治疗的甲状腺功能亢进症患者中，与甲状腺功能亢进症和甲状腺功能正常期相比，快速发生的甲状腺功能减退症患者的血清 FGF21 水平显著升高[中位数分别为 160.55（四分位距，92.48-259.35）与 119.55（67.78-192.32）和 104.43（55.93-231.93）pg/mL，P=0.034 和 0.033]。升高的血清 FGF21 水平与血清甘油三酯呈正相关（Spearman 系数 rs=0.36，P=0.017），与血清 SHBG 呈负相关（rs=-0.41，P=0.007），但与甲状腺激素水平无关。
放射性碘治疗后快速发生的甲状腺功能减退症时，血清 FGF21 水平一过性升高。血清 FGF21 水平与甲状腺激素之间无关联。在放射性碘诱导的甲状腺功能减退症中，升高的血清 FGF21 浓度与升高的血清甘油三酯呈正相关，与下降的 SHBG 呈负相关，反映了肝内脂肪生成增加。
