原发性甲状腺功能减退症患者血脂谱变化的特点

目的 探讨原发性甲状腺功能减退症患者的血清脂蛋白胆固醇亚组分的变化.方法 原发性甲状腺功能减退症患者38例分为临床甲状腺功能减退组(甲减组,20例)、亚临床甲状腺功能减退组(亚甲减组,18例),另选择20例健康体检者作对照(对照组).留取患者空腹静脉血5 ml,分离血清取上清液-80℃冰箱保存,配置密度液,在不同背景密度下超速离心,采用胆固醇氧化酶法测定血清小而密低密度脂蛋白胆固醇(sdLDL-C)、高密度脂蛋白2胆固醇(HDL2-C)、高密度脂蛋白3胆固醇(HDL3-C)的水平.同时检测三碘甲状原氨酸(T3)、甲状腺素(T4)和促甲状腺素(TSH),统计分析其与血清脂蛋白胆固醇亚组分的相关性.结果①甲减组和亚甲减组患者总胆固醇、三酰甘油、LDL胆固醇水平高于对照组,HDL水平低于对照组,差异有统计学意义(P＜0.05);②甲减组和亚甲减组患者sdLDL-C水平高于对照组,差异有统计学意义(P＜0.05);甲减组和亚甲减组血清HDL2-C低于对照组,差异有统计学意义(P＜0.05);HDL3-C组间比较差异无统计学意义;甲减组与亚甲减组sdLDL-C、HDL2-C、HDL3-C比较差异无统计学意义;③原发性甲状腺功能异常发生时,sdLDL-C水平与TSH呈正相关性(r =0.287,P=0.026),与T4呈负相关性(r=-0.267,P =0.039);与T3无相关性;HDL2-C与T3、T4呈正相关性(r =0.271、0.270,P=0.036、0.037);HDL3-C与TSH、T3、T4无明显相关性.结论 甲状腺功能减退症患者的临床血脂谱及脂蛋白胆固醇亚组分产生变化,并与甲状腺功能相关.

Characteristics of serum lipid profiles in patients with primary hypothyroidism

Objective To study the changes of serum lipoprotein cholesterol subclass in patients with primary hypothyroidism).Methods 38 cases of primary hypothyroidism were divided into clinical hypothyroidism group (hypothyroidism group,20 cases) and subclinical hypothyroidism group (subclinical hypothyroidism group,18 cases),Another 20 healthy persons (control group) were selected as control group.5 ml of fasting venous blood was extracted,the serum was separated and preserved at-80 ℃.Configuration of density liquid and ultracentrifugation under different background densities was done.Cholesterol oxidase method was used to determine the serum cholesterol,levels of small and low density lipoprotein (sdLDL),high density lipoprotein 2 (HDL2),and HDL3.At the same time,levels of serum triiodothyronine (T3),thyroxine (T4) and thyroid stimulating hormone (TSH) were checked.Statistical analysis of the correlation between the thyroid relevant hormone mentioned above and serum lipoprotein cholesterol subclass was done.Results ① The total cholesterol,triglycerideand LDL cholesterol levels in hypothyroidism group and subclinical hypothyroidism group were higher than that in the control group,However,the HDL level was significantly lower than the control group (P ＜ 0.05);② SdLDL-C in hypothyroidism group and subclinical hypothyroidism group was significantly higher than that in the control group (P ＜ 0.05);serum HDL2-C in hypothyroidism and subclinical hypothyroidism group was significantly lower than that in the control group (P ＜0.05);while the significance of HDL3 was not reached;sdLDL-C,HDL2-C,HDL3-C in hypothyroidism and subclinical hypothyroidism group had no statistical significance;(Primary thyroid dysfunction occurs,the level of sdLDL-C was positively correlated with TSH (r =0.287,P =0.026),and negatively correlated with T4 (r =-0.267,P =0.039);and no correlation with T3;HDL2-C and T3,T4 were positively correlated (r =0.271,0.270,P =0.036,0.037);no significant correlation between HDL3-C and TSH,T3 T4.Conclusion The changes of clinical lipid profile and lipoprotein cholesterol subclass in patients with hypothyroidism are correlated with thyroid function.