Kung A W, Pang R W, Janus E D
Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Clin Endocrinol (Oxf). 1995 Oct;43(4):445-9. doi: 10.1111/j.1365-2265.1995.tb02616.x.
Asymptomatic lymphocytic thyroiditis and subclinical hypothyroidism are associated with increased risk for coronary artery disease. The present study aimed at evaluating serum lipoprotein(a)(Lp(a)), measured as apo(a), and other lipid parameters in 32 subjects with asymptomatic subclinical hypothyroidism.
Thirty-two Chinese subjects with asymptomatic subclinical hypothyroidism were compared to 96 age and sex-matched healthy controls.
Subclinical hypothyroid patients had higher (P < 0.005) apo(a), total triglyceride (TG), total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) but lower (P < 0.05) high density lipoprotein cholesterol (HDL-C) levels compared with sex and age-matched controls (apo(a) 296 (48-1650) vs 182 (19-1952 U/l), geometric mean (range); TG 1.86 +/- 0.94 vs 1.33 +/- 0.74 mmol/l (mean +/- SD); TC 6.10 +/- 1.17 vs 5.42 +/- 1.13 mmol/l; LDL-C 4.10 +/- 1.00 vs 3.49 +/- 0.96 mmol/l; HDL-C 1.15 +/- 0.40 vs 1.34 +/- 0.40 mmol/l, respectively). APo A-I and apo B were also higher than controls (1.96 +/- 0.48 vs 1.48 +/ 0.29 g/l and 1.44 +/- 0.42 vs 1.05 +/- 0.29 g/l, respectively). Total cholesterol/HDL ratio and LDL/HDL ratio were also elevated in these subjects (5.77 +/- 1.96 vs 4.28 +/- 1.19 and 3.89 +/- 1.41 vs 2.79 +/- 0.97, respectively, both P < 0.0005). Individual analysis revealed that 16 (50%) subjects had hyperlipoproteinaemia (TC > 5.2 mmol/l in 10; TC > 5.2 mmol/l and TG > 2.3 mmol in six) as compared to 21(20.8%) in the control group (P < 0.005). Subjects with TSH > or = 11.0 mIU/l had significantly higher TC/HDL and LDL/HDL ratios. A significant correlation was observed between TSH levels and TC/HDL ratios (r = 0.455, P < 0.01).
Subclinical hypothyroidism is associated not only with elevated LDL-cholesterol levels and low HDL-cholesterol levels but also with elevated lipoprotein (a). This may further increase the risk development of atherosclerosis.
无症状淋巴细胞性甲状腺炎和亚临床甲状腺功能减退与冠状动脉疾病风险增加相关。本研究旨在评估32例无症状亚临床甲状腺功能减退患者的血清脂蛋白(a)[Lp(a)，以载脂蛋白(a) [apo(a)]衡量]及其他血脂参数。
32例无症状亚临床甲状腺功能减退的中国患者与96例年龄和性别匹配的健康对照者进行比较。
与年龄和性别匹配的对照组相比，亚临床甲状腺功能减退患者的apo(a)、总甘油三酯(TG)、总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)水平较高(P < 0.005)，而高密度脂蛋白胆固醇(HDL-C)水平较低(P < 0.05) [apo(a) 296(48 - 1650) vs 182(19 - 1952 U/l)，几何均数(范围)；TG 1.86±0.94 vs 1.33±0.74 mmol/l(均值±标准差)；TC 6.10±1.17 vs 5.42±1.13 mmol/l；LDL-C 4.10±1.00 vs 3.49±0.96 mmol/l；HDL-C 1.15±0.40 vs 1.34±0.40 mmol/l]。载脂蛋白A-I(apo A-I)和载脂蛋白B(apo B)也高于对照组[分别为1.96±0.48 vs 1.48±0.29 g/l和1.44±0.42 vs 1.05±0.29 g/l]。这些患者的总胆固醇/HDL比值和LDL/HDL比值也升高[分别为5.77±1.96 vs 4.28±1.19和3.89±1.41 vs 2.79±0.97，均P < 0.0005]。个体分析显示，16例(50%)患者存在高脂血症(10例TC > 5.2 mmol/l；6例TC > 5.2 mmol/l且TG > 2.3 mmol/l)，而对照组为21例(20.8%)(P < 0.005)。促甲状腺激素(TSH)≥11.0 mIU/l的患者TC/HDL和LDL/HDL比值显著更高。TSH水平与TC/HDL比值之间存在显著相关性(r = 0.455，P < 0.01)。
亚临床甲状腺功能减退不仅与LDL胆固醇水平升高和HDL胆固醇水平降低有关，还与脂蛋白(a)升高有关。这可能会进一步增加动脉粥样硬化的发生风险。
