Verhelst J, Berwaerts J, Marescau B, Abs R, Neels H, Mahler C, De Deyn P P
Department of Endocrinology, Algemeen Ziekenhuis Middelheim, Antwerp, Belgium.
Metabolism. 1997 Sep;46(9):1063-7. doi: 10.1016/s0026-0495(97)90279-1.
Serum levels of creatine (CT), creatinine (CTN), urea, guanidinosuccinic acid (GSA), guanidinoacetic acid (GAA), guanidine (G), arginine (Arg), homoarginine (Harg), argininic acid (ArgA), and alpha-keto-delta-guanidinovaleric acid (alpha-K-delta-GVA) were measured in 54 patients with hyperthyroidism, 56 with subclinical hyperthyroidism, 28 with subclinical hypothyroidism, and 51 with hypothyroidism compared with 62 euthyroid controls. In agreement with previous reports, serum CT increased (+35%) and CTN decreased (-17.6%) in hyperthyroidism as compared with normal thyroid function, whereas the opposite was seen in hypothyroidism (-17.7% and +11%, P < .0001). Original findings from this study are a highly significant decrease in GSA (-41.7%) and GAA (-36.8%) in hyperthyroidism and an increase in GSA (+36%) in hypothyroidism (P < .0001). In addition, a slight decrease in hyperthyroidism and hypothyroidism was noted for Arg (-6.2% and -13.2%, P = .001) and Harg (-14.8% and -18.1%, P = .05). By contrast, no significant change was seen in levels of urea, G, ArgA, and alpha-K-delta-GVA. No major differences were found for any of the compounds between subclinical hypothyroidism, euthyroidism, and subclinical hyperthyroidism. There was a highly significant positive linear correlation between urea and GSA levels in hyperthyroidism, euthyroidism, and hypothyroidism (r = .68, r = .77, and r = .75, P < .0001), taking into account that for the same increase in urea, GSA increased threefold more in hypothyroid versus hyperthyroid patients. In conclusion, apart from CT and CTN, significant changes can be found in serum levels of GSA, GAA, Arg, and Harg in patients with thyroid dysfunction. Subclinical thyroid dysfunction does not seem to induce changes in serum levels of guanidino compounds. Decreased serum GSA and GAA levels might be an additional indicator of hyperthyroidism.
对54例甲状腺功能亢进患者、56例亚临床甲状腺功能亢进患者、28例亚临床甲状腺功能减退患者和51例甲状腺功能减退患者测定了血清肌酸（CT）、肌酐（CTN）、尿素、胍基琥珀酸（GSA）、胍基乙酸（GAA）、胍（G）、精氨酸（Arg）、高精氨酸（Harg）、精氨酸酸（ArgA）和α-酮-δ-胍基戊酸（α-K-δ-GVA）水平，并与62例甲状腺功能正常的对照者进行比较。与既往报道一致，与正常甲状腺功能相比，甲状腺功能亢进时血清CT升高（+35%），CTN降低（-17.6%），而甲状腺功能减退时则相反（-17.7%和+11%，P<.0001）。本研究的原始发现是，甲状腺功能亢进时GSA（-41.7%）和GAA（-36.8%）显著降低，甲状腺功能减退时GSA升高（+36%）（P<.0001）。此外，甲状腺功能亢进和甲状腺功能减退时Arg（-6.2%和-13.2%，P=.001）和Harg（-14.8%和-18.1%）略有降低。相比之下，尿素、G、ArgA和α-K-δ-GVA水平未见显著变化。亚临床甲状腺功能减退、甲状腺功能正常和亚临床甲状腺功能亢进之间，任何一种化合物均未发现重大差异。在甲状腺功能亢进、甲状腺功能正常和甲状腺功能减退时尿素和GSA水平之间存在高度显著正线性相关（r=.68、r=.77和r=.75,P<.0001），考虑到尿素相同程度的升高，甲状腺功能减退患者的GSA升高幅度是甲状腺功能亢进患者的3倍。总之，除CT和CTN外，甲状腺功能障碍患者血清GSA、GAA、Arg和Harg水平可出现显著变化。亚临床甲状腺功能障碍似乎不会引起胍基化合物血清水平的变化。血清GSA和GAA水平降低可能是甲状腺功能亢进的另一个指标。
