[甲状腺疾病治疗期间高密度脂蛋白胆固醇的变化]

[Variation in high density lipoprotein cholesterol during treatment of thyroid gland diseases].

作者信息

Barbier R, Paffoy J C, Venard-Sassolas A, Berthezene F

出版信息

Diabete Metab. 1980 Sep;6(3):213-7.

Abstract

Serum cholesterol concentration is usually increased in primary hypothyroidism and decreased in hyperthyroidism. The role of hypercholesterolemia in hypothyroidism as a causal factor for coronary atherosclerosis has been extensively discussed. Epidemiologic studies have stablished that there is a very strong negative correlation between plasma HDL cholesterol levels and coronary atherosclerosis. Plasma concentration of HDL cholesterol was determined in 36 controls after separation of HDL from other lipoproteins by ultracentrifugation (uc), by precipitation by heparin-manganese chloride (hmc) and by phosphotungstate magnesium chloride (pmc). The recovery of HDL after both precipitations was almost 100% as shown by HDL immunoassay (kit Behring). There was a very strong correlation between cholesterol HDL values obtained by uc and hmc (r = 0.91) and by uc and pmc (r = 0.90). Normal values were 1.22 +/- 0.27 mmol/1 (mean +/- SD) in males and 1.57 +/- 0.31 mmol/L in females. We have measured HDL cholesterol by both precipitation technics in 17 hypothyroid patients before and under treatment for at least 2 months. Plasma total cholesterol levels were 7.01 +/- 2.61 mmol/1 before and 4.94 +/- 0.85 mmol/1 after treatment (p < 0.001); in contrast plasma HDL cholesterol did not change (1.29 +/- 0.33 vs 1.28 +/- 0.38 mmol/1). In 11 hyperthyroid patients plasma total cholesterol was 4.14 +/- 1.03 before and 5.74 +/- 0.88 mmol/l after recovery (p < 0.001). The mean plasma HDL cholesterol did not change (1.43 +/- 0.23 vs 1.59 +/- 0.42 mmol/1). However, 5 out of 11 patients had an increase of more than 10% of the plasma HDL cholesterol levels.

摘要

原发性甲状腺功能减退症患者血清胆固醇浓度通常会升高，而甲状腺功能亢进症患者血清胆固醇浓度则会降低。高胆固醇血症在甲状腺功能减退症中作为冠状动脉粥样硬化病因的作用已得到广泛讨论。流行病学研究证实，血浆高密度脂蛋白胆固醇（HDL）水平与冠状动脉粥样硬化之间存在非常强的负相关。通过超速离心法（uc）、肝素-氯化锰沉淀法（hmc）和磷钨酸-氯化镁沉淀法（pmc）将HDL与其他脂蛋白分离后，测定了36名对照者的血浆HDL胆固醇浓度。如HDL免疫测定法（拜耳试剂盒）所示，两种沉淀法后HDL的回收率几乎为100%。通过uc法与hmc法测得的胆固醇HDL值之间（r = 0.91）以及uc法与pmc法测得的胆固醇HDL值之间（r = 0.90）存在非常强的相关性。男性的正常数值为1.22±0.27 mmol/1（平均值±标准差），女性为1.57±0.31 mmol/L。我们采用两种沉淀技术对17例甲状腺功能减退症患者在治疗前及至少治疗2个月后进行了HDL胆固醇测定。治疗前血浆总胆固醇水平为7.01±2.61 mmol/1，治疗后为4.94±0.85 mmol/1（p < 0.001）；相比之下，血浆HDL胆固醇未发生变化（分别为1.29±0.33与1.28±0.38 mmol/1）。11例甲状腺功能亢进症患者治疗前血浆总胆固醇为4.14±1.03，恢复后为5.74±0.88 mmol/l（p < 0.001）。血浆HDL胆固醇平均值未发生变化（分别为1.43±0.23与1.59±0.42 mmol/1）。然而，11例患者中有5例血浆HDL胆固醇水平升高超过10%。