异维A酸对血脂、脂蛋白、肝脏及甲状腺功能的影响。

Effects of isotretinoin on serum lipids and lipoproteins, liver and thyroid function.

作者信息

Marsden J R, Trinick T R, Laker M F, Shuster S

出版信息

Clin Chim Acta. 1984 Nov 30;143(3):243-51. doi: 10.1016/0009-8981(84)90074-3.

Abstract

Seven patients with severe rosacea were treated with 1 mg/kg per day isotretinoin for 12 wk. There were significant increases in serum triglyceride (p less than 0.001) and cholesterol (p less than 0.001). Triglyceride associated with very low density lipoprotein (VLDL), low density lipoprotein (LDL) and high density lipoprotein (HDL) increased (p less than 0.01), cholesterol in VLDL and LDL increased (p less than 0.01), and levels of HDL cholesterol decreased (p less than 0.01). There were changes in indices of liver function, with increased levels of gamma-glutamyltransferase (GGT) (p less than 0.01), alkaline phosphatase (ALP) (p less than 0.01) and aspartate aminotransferase (AST) (p less than 0.01), and decreased bilirubin levels (p less than 0.05). Although levels of thyroxine and triiodothyronine were lower after treatment (p less than 0.05), there were no changes in basal levels of thyroid-stimulating hormone (TSH), luteinizing hormone (LH) or follicle-stimulating hormone (FSH), and responses to thyrotrophin releasing hormone (TRH) and luteinizing hormone releasing hormone (LHRH) were unchanged. These changes may partially be explained by induction of hepatic microsomal enzymes by isotretinoin.

摘要

7例重度酒渣鼻患者接受每天1mg/kg异维A酸治疗，疗程12周。血清甘油三酯（p<0.001）和胆固醇（p<0.001）显著升高。与极低密度脂蛋白（VLDL）、低密度脂蛋白（LDL）和高密度脂蛋白（HDL）相关的甘油三酯升高（p<0.01），VLDL和LDL中的胆固醇升高（p<0.01），HDL胆固醇水平降低（p<0.01）。肝功能指标发生变化，γ-谷氨酰转移酶（GGT）（p<0.01）、碱性磷酸酶（ALP）（p<0.01）和天冬氨酸转氨酶（AST）（p<0.01）水平升高，胆红素水平降低（p<0.05）。虽然治疗后甲状腺素和三碘甲状腺原氨酸水平降低（p<0.05），但促甲状腺激素（TSH）、黄体生成素（LH）或卵泡刺激素（FSH）的基础水平无变化，对促甲状腺激素释放激素（TRH）和黄体生成素释放激素（LHRH）的反应也未改变。这些变化可能部分由异维A酸诱导肝微粒体酶来解释。