自身免疫性甲状腺功能减退患者肥胖及脂代谢的研究

目的:探讨自身免疫性甲状腺功能减退患者甲状腺球蛋白抗体(Thyroglobulin antibody TGAb)、甲状腺过氧化物酶抗体(Thyroperoxidase antibody TPOAb)与肥胖及脂代谢的关系.方法:选择桥本氏甲状腺炎(Hashimoto thyroiditis HT)女性239名,分为甲减组58例、亚临床甲减组69例、甲功正常组112例,测量腰围(waist circumstance WC)、臀围并计算腰臀比(waist hip ratio WHR),实验室检测促甲状腺素(thyroid stimulating hormone TSH)、TGAb和TPOAb,脂代谢相关参数总胆固醇(total cholesterol TC)、甘油三酯(triglyceride TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol LDL-C)等.结果:三组之间WC、TC与TG存在显著差异(P<0.05),WHR则无明显差异(P>0.05).三组WC均与TPOAb存在明显相关性(r=0.384,r=0.369,r=0.307,P<0.05),三组TPOAb与TC存在明显正相关(r=0.431,r=0.387,r=0.381,P<0.05),与HDL-C存在明显负相关(r=-0.356,r=-0.343,r=-0.312,P<0.05).结论:自身免疫性甲状腺功能减退患者存在明显的腹型肥胖及脂代谢异常,自身免疫的损伤程度可能与脂代谢紊乱有关.

Obesity and Lipid Metabolism in Patients with Autoimmune Hypothyroidism

Objective: To study the relationship between thyroglobulin antibody(TGAb),hyroperoxidase antibody(TPOAb),obesity and lipid metabolism in patients with autoimmune hypothyroidism.Method: 239 women with Hashimoto’s thyroiditis(HT) were divided into 58 cases of hypothyroidism,69 cases of subclinical hypothyroidism,112 cases of normal thyroid function group.Waist circumference(WC),hip circumference were measured and waist hip ratio(WHR) were calculated.The levels of thyroid stimulating hormone(TSH),TGAb and TPOAb,lipid metabolism-related parameters total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C) were tested in laboratory.Result: TC and TG were significantly different(P <0.05) among the three groups WC,but no significant difference of WHR(P> 0.05).WC were significantly correlated(r = 0.384,r = 0.369,r = 0.307,P <0.05) with the TPO-AB in three groups,and TPO-Ab was positively correlated with TC(r = 0.431,r = 0.387,r = 0.381,P <0.05),negative correlated with HDL-C(r =-0.356,r =-0.343,r =-0.312,P <0.05) in three groups.Conclusion: There were obvious abdominal obesity and abnormal lipid metabolism in patients with autoimmune hypothyroidism.Autoimmune injury may be associated with lipid metabolism disorders.