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探索甲状腺功能减退对血脂谱的影响:亚临床疾病中代谢后果的证据。

Exploring hypothyroidism's effects on lipid profiles: Evidence of metabolic consequences in subclinical disease.

作者信息

Alnahdi Haifa M

机构信息

From the Department of Internal Medicine, Endocrinology Division, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.

出版信息

Saudi Med J. 2025 May;46(5):491-496. doi: 10.15537/smj.2025.46.5.20241147.

Abstract

OBJECTIVES

To investigate the association between thyroid-stimulating hormone (TSH) levels and lipid profiles in patients with subclinical hypothyroidism (SCH) to assess the metabolic risks.

METHODS

This retrospective study included patients diagnosed with SCH between January 2023 and August 2024. Thyroid function markers (TSH, free triiodothyronine, and free thyroxine levels) and lipid profiles (total cholesterol, low-density lipoprotein, high-density lipoprotein, and triglyceride levels) were assessed in 137 patients.

RESULTS

The mean age of patients was 44.6±13.6 years, with 86.1% being female and 92.7% having dyslipidemia. Thyroid-stimulating hormone levels were correlated with serum creatinine levels (r=0.27, =0.001) and showed a non-significant trend toward higher cholesterol levels (r=0.15, =0.09). Free thyroxine were significantly lower in women (=0.035) and in patients with hypertriglyceridemia (n=32; =0.005), showing an inverse correlation (r= -0.2; =0.02). Free triiodothyronine were lower in patients with obesity (=0.003) and inversely associated with body mass index (BMI, r= -0.2, =0.019). Serum creatinine levels independently predict TSH levels, whereas triglyceride levels inversely predict free thyroxine levels.

CONCLUSION

Subclinical hypothyroidism impairs lipid metabolism, particularly in females with high BMI. Triglycerides suppress free thyroxine levels, whereas elevated TSH levels correlate with increased creatinine levels. Our findings suggest a potential relationship between SCH and lipid alterations, warranting further investigation into targeted lipid management in these patients.

摘要

目的

研究亚临床甲状腺功能减退症(SCH)患者促甲状腺激素(TSH)水平与血脂谱之间的关联,以评估代谢风险。

方法

这项回顾性研究纳入了2023年1月至2024年8月期间被诊断为SCH的患者。对137例患者的甲状腺功能指标(TSH、游离三碘甲状腺原氨酸和游离甲状腺素水平)和血脂谱(总胆固醇、低密度脂蛋白、高密度脂蛋白和甘油三酯水平)进行了评估。

结果

患者的平均年龄为44.6±13.6岁,其中86.1%为女性,92.7%患有血脂异常。促甲状腺激素水平与血清肌酐水平相关(r=0.27,P=0.001),且胆固醇水平有升高的非显著趋势(r=0.15,P=0.09)。女性(P=0.035)和高甘油三酯血症患者(n=32;P=0.005)的游离甲状腺素显著降低,呈负相关(r=-0.2;P=0.02)。肥胖患者的游离三碘甲状腺原氨酸较低(P=0.003),且与体重指数(BMI,r=-0.2,P=0.019)呈负相关。血清肌酐水平独立预测TSH水平,而甘油三酯水平反向预测游离甲状腺素水平。

结论

亚临床甲状腺功能减退会损害脂质代谢,尤其是在高BMI的女性中。甘油三酯会抑制游离甲状腺素水平,而TSH水平升高与肌酐水平升高相关。我们的研究结果表明SCH与脂质改变之间存在潜在关系,有必要对这些患者的靶向脂质管理进行进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b76a/12074050/5acd735982e4/SMJ-46-5-491_1.jpg

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