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分化型甲状腺癌术后患者短期快速甲状腺功能减退与血脂水平的关系。

The relationships between thyroid functions of short-term rapid hypothyroidism and blood lipid levels in post-thyroidectomy patients of differentiated thyroid cancer.

机构信息

Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Nephrology, Ji-nan, China.

Department of Endocrinology and Metabology, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Ji-nan, China.

出版信息

Front Endocrinol (Lausanne). 2023 Apr 27;14:1114344. doi: 10.3389/fendo.2023.1114344. eCollection 2023.

Abstract

OBJECTIVE

To explore the relationship between short-term rapid hypothyroidism and blood lipid levels in patients with differentiated thyroid cancer (DTC).

METHODS

Seventy-five DTC patients scheduled to receive radioactive iodine ablation were enrolled. Levels of thyroid hormone and serum lipids were tested at two time points: the euthyroid before thyroidectomy, and the hypothyroid (off thyroxine). Then the collected data were analyzed.

RESULTS

Totally 75 DTC patients enrolled, among them, 5o were female (66.67%) and 25 were male (33. 33%), with an average age of 52.24 ± 1.24 years old. The short-term rapid severe hypothyroidism induced by thyroid hormone withdrawal significantly aggravated dyslipidemia, particularly in patients with dyslipidemia before thyroidectomy (All < 0.01). However, there was no significant differences between blood lipid levels with different thyroid stimulating hormone (TSH) levels. And our study showed significant negative correlations between free triiodothyronine levels and the changes from euthyjroidism to hypothyroidism in total cholesterol (r=-0.31, =0.03), triglycerides (r=-0.39, =0.006), high density lipoprotein-cholesterol (HDL-C) (r=-0.29, =0.042), and significant positive correlations between free thyroxine and the changes of HDL-C (r=-0.32, =0.027) were identified in females, however, which were not observed in males.

CONCLUSION

Short-term rapids severe hypothyroidism caused by thyroid hormone withdrawal can lead to rapid significant changes in blood lipid levels. It is necessary to pay attention to dyslipidemia and its long-term effects after thyroid hormone withdrawal, especially in patients with dyslipidemia before thyroidectomy.

CLINICAL TRIAL REGISTRATION

https://clinicaltrials.gov/ct2/show/NCT03006289?term=NCT03006289&draw=2&rank=1, identifier NCT03006289.

摘要

目的

探讨分化型甲状腺癌(DTC)患者短期快速甲状腺功能减退与血脂水平的关系。

方法

选取 75 例行放射性碘消融治疗的 DTC 患者。分别在甲状腺切除术前的甲状腺功能正常和甲状腺激素停药后的甲状腺功能减退期检测甲状腺激素和血清脂质水平。然后分析收集的数据。

结果

共纳入 75 例 DTC 患者,其中女性 50 例(66.67%),男性 25 例(33.33%),平均年龄 52.24±1.24 岁。甲状腺激素停药引起的短期快速严重甲状腺功能减退显著加重了血脂异常,尤其是在甲状腺切除术前有血脂异常的患者(均<0.01)。然而,不同促甲状腺激素(TSH)水平的血脂水平之间没有显著差异。我们的研究表明,游离三碘甲状腺原氨酸水平与从甲状腺功能正常到甲状腺功能减退的总胆固醇(r=-0.31,=0.03)、甘油三酯(r=-0.39,=0.006)、高密度脂蛋白胆固醇(HDL-C)(r=-0.29,=0.042)的变化之间存在显著负相关,而游离甲状腺素与 HDL-C 变化之间存在显著正相关(r=-0.32,=0.027),这在女性中得到了证实,但在男性中未观察到。

结论

甲状腺激素停药引起的短期快速严重甲状腺功能减退可导致血脂水平迅速显著变化。有必要关注甲状腺激素停药后血脂异常及其长期影响,特别是在甲状腺切除术前有血脂异常的患者。

临床试验注册

https://clinicaltrials.gov/ct2/show/NCT03006289?term=NCT03006289&draw=2&rank=1,标识符 NCT03006289。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fc8/10173361/dab5aa98f4e3/fendo-14-1114344-g001.jpg

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