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特纳综合征患者的甲状腺功能会对其肌肉力量产生重大影响吗?

Might Thyroid Function in Patients with Turner Syndrome Have a Significant Impact on Their Muscle Strength?

作者信息

Krzyscin Mariola, Sowińska-Przepiera Elżbieta, Bumbulienė Žana, Syrenicz Anhelli

机构信息

Pediatric, Adolescent Gynecology Clinic, Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland.

Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland.

出版信息

Int J Mol Sci. 2025 Apr 13;26(8):3679. doi: 10.3390/ijms26083679.

Abstract

Turner syndrome (TS) is a genetic disorder caused by abnormalities in one of the X chromosomes. Individuals with TS have a higher incidence of autoimmune thyroid disorders, particularly Hashimoto's disease, leading to thyroid dysfunction, most commonly hypothyroidism. Hormonal imbalance, growth hormone deficiency, and reduced physical activity contribute to muscle weakness in TS patients, and thyroid dysfunction can exacerbate these effects. The purpose of this study was to evaluate whether thyroid factors affect muscle strength in female patients with TS. The study included 70 women with TS and 88 age- and weight-matched controls. TS diagnoses were genetically confirmed (mosaic karyotypes: = 20; monosomy X: = 37; structural abnormalities: = 7). The main criterion for exclusion from the study was unbalanced thyroid function. Serum levels of thyroid-stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), and thyroid antibodies (anti-thyroid peroxidase antibodies (aTPO), anti-thyroglobulin antibodies (aTG)) were measured, and muscle strength was assessed using hand-held dynamometry. In TS patients, higher TSH levels were positively correlated, and higher fT4 levels were negatively correlated with muscle strength. No such correlations were found in controls. Thyroid compensation may impact musculoskeletal health in TS. Lower-normal TSH levels are associated with reduced muscle strength, and autoimmune thyroid changes like aTPO and aTG may contribute to muscle deterioration. Further research is needed to confirm these findings.

摘要

特纳综合征(TS)是一种由X染色体异常引起的遗传性疾病。患有TS的个体自身免疫性甲状腺疾病的发病率较高,尤其是桥本氏病,会导致甲状腺功能障碍,最常见的是甲状腺功能减退。激素失衡、生长激素缺乏和体力活动减少导致TS患者出现肌肉无力,而甲状腺功能障碍会加剧这些影响。本研究的目的是评估甲状腺因素是否会影响女性TS患者的肌肉力量。该研究纳入了70名患有TS的女性和88名年龄及体重匹配的对照者。TS诊断经基因确认(嵌合核型:=20;X单体型:=37;结构异常:=7)。排除该研究的主要标准是甲状腺功能不平衡。测量了血清促甲状腺激素(TSH)、游离甲状腺素(fT4)、游离三碘甲状腺原氨酸(fT3)和甲状腺抗体(抗甲状腺过氧化物酶抗体(aTPO)、抗甲状腺球蛋白抗体(aTG))的水平,并使用手持测力计评估肌肉力量。在TS患者中,较高的TSH水平与肌肉力量呈正相关,较高的fT4水平与肌肉力量呈负相关。在对照者中未发现此类相关性。甲状腺代偿可能会影响TS患者的肌肉骨骼健康。较低的正常TSH水平与肌肉力量降低有关,而aTPO和aTG等自身免疫性甲状腺变化可能会导致肌肉退化。需要进一步的研究来证实这些发现。

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本文引用的文献

1
Evolution of Health Care in Turner Syndrome.特纳综合征医疗保健的发展
Am J Med Genet C Semin Med Genet. 2025 Mar;199(1):e32124. doi: 10.1002/ajmg.c.32124. Epub 2024 Nov 29.
3
Lifelong medical challenges and immunogenetics of Turner syndrome.特纳综合征的终身医学挑战与免疫遗传学
Clin Exp Pediatr. 2024 Nov;67(11):560-568. doi: 10.3345/cep.2024.00430. Epub 2024 Jul 31.

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