Department of Medicine, Karnataka Institute of Medical Sciences, Huballi, India.
Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Mangalagiri, India,
Arch Endocrinol Metab. 2022 Nov 17;66(6):808-814. doi: 10.20945/2359-3997000000511. Epub 2022 Aug 4.
The aim of this study was to assess the effect of hyperthyroidism and its treatment on body weight and composition, insulin resistance, and mediators of appetite and energy homeostasis, namely ghrelin, leptin, adiponectin, and fibroblast growth factor 21 (FGF21).
Thirty-five adult patients (27 female and 8 male, aged 39.63 ± 9.70 years) with overt hyperthyroidism were evaluated for leptin, ghrelin, adiponectin, and FGF21 levels; insulin resistance; and body composition using DEXA both at baseline and a minimum of two months following normalization of serum thyroxin on carbimazole treatment. Comparison of means between the baseline and post treatment values was performed by the paired t test for normally distributed parameters and by the Wilcoxon signed-rank test for non-normally distributed data.
Hyperthyroidism correction resulted in an increase in weight from 51.15 ± 8.50 kg to 55.74 ± 8.74 kg ( < 0.001), paradoxically accompanied by a decrease in insulin resistance as measured by HOMA-IR from 1.35 (1.02-1.72) to 0.73 (0.52-0.93) ( < 0.001). Correction of hyperthyroidism was also associated with a decrease in FGF21 from 58 (55-64) to 52 (47-58) pg/mL ( < 0.001) and in leptin levels from 17 (7-36) to 11 (4.6-28) ng/mL ( = 0.03).
Despite lower body weight, thyrotoxicosis is associated with insulin resistance. High levels of thermogenic hormones, leptin, and FGF21 were observed in thyrotoxicosis and may be partly responsible for the excessive heat production typical of this condition.
本研究旨在评估甲状腺功能亢进及其治疗对体重和成分、胰岛素抵抗以及食欲和能量稳态的介质（即 ghrelin、瘦素、脂联素和成纤维细胞生长因子 21（FGF21））的影响。
35 名成年甲状腺功能亢进患者（27 名女性和 8 名男性，年龄 39.63 ± 9.70 岁）接受了瘦素、ghrelin、脂联素和 FGF21 水平、胰岛素抵抗以及使用 DEXA 评估身体成分，基线时和卡比马唑治疗后血清甲状腺素正常化至少两个月。使用配对 t 检验对正态分布参数和 Wilcoxon 符号秩检验对非正态分布数据进行比较均值。
甲状腺功能亢进症的纠正导致体重从 51.15 ± 8.50 kg 增加到 55.74 ± 8.74 kg（<0.001），但出乎意料的是，HOMA-IR 衡量的胰岛素抵抗从 1.35（1.02-1.72）降低到 0.73（0.52-0.93）（<0.001）。甲状腺功能亢进症的纠正还与 FGF21 从 58（55-64）降至 52（47-58）pg/mL（<0.001）和瘦素水平从 17（7-36）降至 11（4.6-28）ng/mL（=0.03）有关。
尽管体重较低，但甲状腺毒症与胰岛素抵抗有关。在甲状腺毒症中观察到高浓度的产热激素、瘦素和 FGF21，它们可能部分解释了这种情况的典型过度产热。
