甲状腺功能正常人群血清促甲状腺激素水平与血脂的相关性

目的探讨甲状腺功能正常人群血清促甲状腺激素(TSH)水平与血脂水平的相关性。方法选取2018年4月至2019年4月在北京朝阳医院体检中心进行健康体检的2754名体检人员为研究对象。检测其血游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、TSH、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)水平。所有研究对象的血TSH、FT3、FT4均在参考值范围内。比较男性和女性人群的一般临床资料及血脂水平。以TSH水平1.0和1.9为界值,对人群进行分组,低于1.0定义为正常低值组,高于1.9定义为正常高值组,介于两者之间定义为正常中值组。比较不同人群在不同TSH水平下的血脂水平差异。采用多元线性回归分析TSH水平与各血脂水平的相关性。结果男性人群的吸烟史、高血压及糖尿病比例、体质指数、FT3、FT4和TG水平显著高于女性,而年龄、TSH、TC和HDL-C水平显著低于女性(均为P<0.01)。在总体人群中,TSH正常高值组的HDL-C水平显著高于正常中值组,同时TC水平显著高于正常低值组和正常中值组(均为P<0.05)。在女性人群中,TSH正常高值组和正常中值组的TG水平均显著高于正常低值组,而正常高值组又显著高于正常中值组(均为P<0.05)。多元线性回归分析表明,TSH水平与TC和TG呈正相关,且这种相关性独立于甲状腺激素(β=0.056,P=0.010;β=0.075,P=0.004)。结论在甲状腺功能正常的人群中,TSH水平与TC、TG呈显著正相关,TSH水平在正常范围内升高可能是血脂升高的危险因素。

Correlation between serum thyroid-stimulating hormone and blood lipid in subjects with normal thyroid function

Objective To investigate the relationship between serum thyroid-stimulating hormone and blood lipid in the population with normal thyroid function.Methods A total of 2754 participants who underwent a medical examination at the Medical Center of Beijing Chao-yang Hospital were selected as research subjects between April 2018 and April 2019.The free triiodothyronine(FT3),free thyroxine(FT4),TSH,total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)and low-density lipid Protein cholesterol(LDL-C)levels were tested.TSH,FT3,and FT4 were all within the reference range.General clinical data and lipid levels were compared between male and female populations.The participants were divided into three groups.TSH of the normal high value group was higher than 1.69 while that of the normal low value group was lower than 1.0.The range between 1.0 and 1.9 is defined as the normal median group.The differences of serum lipid levels in different populations were compared under different TSH levels.Multiple linear regression was to analyze the correlation between TSH level and various lipid levels.Results The proportion of smoking,hypertension and diabetes of the male population,and BMI,FT3,FT4,TG levels of the male population were significantly higher than those of the female population,while the age,TSH,TC,HDL-C of the male population were significantly lower than those of the female population(P<0.01).In the total population,the HDL-C level in the TSH normal high value group was higher than the normal median group and the TC level in the TSH normal high value group was higher than in the normal median group and the normal low value group(P<0.05).In the female population,the levels of TG in the normal high value group and the normal median group were higher than in the normal low value group and it was higher in the normal high value group than in the normal median group(P<0.05).The multiple linear regression analysis showed that the TSH level was positively correlated with TC and TG and this correlation was independent of thyroid hormone(β=0.056,P=0.010;β=0.075,P=0.004).Conclusions In the population with normal thyroid function,TSH level was positively correlated with TC and TG.The increase in TSH level within the normal range may be a risk factor for the elevated blood lipids.