Sato A, Shirota T, Shinoda T, Komiya I, Aizawa T, Takemura Y, Yamada T
Department of Medicine, Dokkyo Medical College, Koshigaya Hospital, Saitama, Japan.
Metabolism. 1995 Feb;44(2):207-11. doi: 10.1016/0026-0495(95)90266-x.
The effects of hyperthyroidism on uric acid metabolism were investigated. First, the serum uric acid level was measured in 92 patients with hyperthyroidism due to Graves' disease, eight patients with subacute thyroiditis, six patients with hypothyroidism, and 70 sex- and age-matched controls. Second, the correlation between serum thyroxine (T4) and serum uric acid was obtained in hyperthyroid Graves' disease patients before and during antithyroid drug therapy. Finally, uric acid clearance (CUA) was determined in untreated patients with hyperthyroidism due to Graves' disease. Serum uric acid was significantly elevated in patients with hyperthyroidism, and the elevation correlated well with serum T4 before treatment as a group and during treatment in each patient. A significant elevation of serum uric acid was not present in patients with a transient mild thyrotoxicosis due to subacute thyroiditis. Serum uric acid was significantly decreased in patients with hypothyroidism. Renal excretion of uric acid clearly increased in hyperthyroid patients, and CUA also increased. The increase in CUA corresponded to the increase in renal plasma flow (RPF), which was measured by p-aminohippuric acid clearance. The fractional excretion of uric acid as determined by CUA/glomerular filtration rate (GFR) was similar and within the normal range in hyperthyroid patients and normal controls. A significant inverse correlation between CUA and serum uric acid concentration was present in hyperthyroid patients as in normal controls, indicating that the renal handling of uric acid in the tubule affected uric acid excretion.(ABSTRACT TRUNCATED AT 250 WORDS)
研究了甲状腺功能亢进对尿酸代谢的影响。首先，测定了92例格雷夫斯病所致甲状腺功能亢进患者、8例亚急性甲状腺炎患者、6例甲状腺功能减退患者以及70例年龄和性别匹配的对照者的血清尿酸水平。其次，在甲状腺功能亢进的格雷夫斯病患者抗甲状腺药物治疗前及治疗期间，得出血清甲状腺素（T4）与血清尿酸之间的相关性。最后，测定了未经治疗的格雷夫斯病所致甲状腺功能亢进患者的尿酸清除率（CUA）。甲状腺功能亢进患者的血清尿酸显著升高，且这种升高在治疗前作为一组以及治疗期间的每位患者中均与血清T4密切相关。亚急性甲状腺炎所致短暂轻度甲状腺毒症患者的血清尿酸没有显著升高。甲状腺功能减退患者的血清尿酸显著降低。甲状腺功能亢进患者的尿酸肾排泄明显增加，CUA也增加。CUA的增加与通过对氨基马尿酸清除率测定的肾血浆流量（RPF）的增加相对应。通过CUA/肾小球滤过率（GFR）测定的尿酸排泄分数在甲状腺功能亢进患者和正常对照者中相似且在正常范围内。与正常对照者一样，甲状腺功能亢进患者中CUA与血清尿酸浓度之间存在显著的负相关，表明肾小管对尿酸的处理影响尿酸排泄。（摘要截断于250字）
