甲状腺功能亢进症治疗前后的血清脂质及载脂蛋白A-I、A-II和B

Serum lipids and apolipoproteins A-I, A-II, and B in hyperthyroidism before and after treatment.

作者信息

Muls E, Blaton V, Rosseneu M, Lesaffre E, Lamberigts G, De Moor P

出版信息

J Clin Endocrinol Metab. 1982 Sep;55(3):459-64. doi: 10.1210/jcem-55-3-459.

Abstract

The serum concentrations of total cholesterol (TC), triglycerides (RG), high density lipoprotein-cholesterol (HDLc), low density lipoprotein-cholesterol (LDLc), and the apolipoproteins (apo) A-I, A-II, and B were measured in 33 hyperthyroid patients before and after treatment. The results were compared with those of healthy controls. Apo A-I, A-II, and B were assayed by immunonephelometry. The serum levels of TC (mean +/- SD, 167 +/- 36 mg/dl, HDLc (40.8 +/- 12 mg/dl), and LDLc (108 +/- 35 mg/dl) were decreased in the untreated hyperthyroid patients compared to both the values after treatment (TC: 215 +/- 54 mg/dl; P less than 0.001; HDLc: 52 +/- 14 mg/dl; P less than 0.001; LDLc: 146 +/- 47 mg/dl; P less than 0.001) and the control values (TC: 206 + 39 mg/dl; P less than 0.001; HDLc: 47.4 +/- 10 mg/dl; P les than 0.01; LDLc: 145 +/- 38 mg/dl; P less than 0.001). TG levels were not statistically different before and after treatment. The apo A-I concentrations (116 +/- 24 mg/dl) were lower before than after treatment (131 +/- 28 mg/dl; P less than 0.01), but they were not statistically different from those in the control group (115 +/- 19 mg/dl). The apo A-II levels were identical in all groups (before treatment, 35 +/- 7 mg/dl; after treatment, 37 +/- 9 mg/dl; control group, 36 +/- 9 mg/dl). The apo B levels were lower in the untreated hyperthyroid patients (86 +/- 23 mg/dl) compared to those in controls (103 +/- 19 mg/dl; P less than 0.001) and patients after therapy (103 +/- 25 mg/dl; P less than 0.001). The increase in HDLc relative to the major HDL apo A-I and A-II during treatment for hyperthyroidism was associated with changes in body weight. The apo A-I to apo A-II and LDLc to apo B ratios, however, were significantly lower before compared to those after treatment, when the influence of increasing body weight during therapy was accounted for. This study emphasizes the important regulating role of thyroid hormones on lipid and apolipoprotein metabolism.

摘要

对33例甲状腺功能亢进患者在治疗前后测定了血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDLc）、低密度脂蛋白胆固醇（LDLc）以及载脂蛋白（apo）A-I、A-II和B的浓度。将结果与健康对照者的结果进行比较。apo A-I、A-II和B采用免疫比浊法测定。与治疗后的值（TC：215±54mg/dl；P＜0.001；HDLc：52±14mg/dl；P＜0.001；LDLc：146±47mg/dl；P＜0.001）以及对照值（TC：206+39mg/dl；P＜0.001；HDLc：47.4±10mg/dl；P＜0.01；LDLc：145±38mg/dl；P＜0.001）相比，未经治疗的甲状腺功能亢进患者的血清TC水平（均值±标准差，167±36mg/dl）、HDLc水平（40.8±12mg/dl）和LDLc水平（108±35mg/dl）均降低。治疗前后TG水平无统计学差异。apo A-I浓度（116±24mg/dl）治疗前低于治疗后（131±28mg/dl；P＜0.01），但与对照组（115±19mg/dl）无统计学差异。所有组的apo A-II水平相同（治疗前，35±7mg/dl；治疗后，37±9mg/dl；对照组，36±9mg/dl）。与对照组（103±19mg/dl；P＜0.001）和治疗后的患者（103±25mg/dl；P＜0.001）相比，未经治疗的甲状腺功能亢进患者的apo B水平较低（86±23mg/dl）。甲状腺功能亢进治疗期间HDLc相对于主要HDL载脂蛋白A-I和A-II的增加与体重变化有关。然而，当考虑到治疗期间体重增加的影响时，治疗前的apo A-I与apo A-II以及LDLc与apo B的比值显著低于治疗后。本研究强调了甲状腺激素对脂质和载脂蛋白代谢的重要调节作用。