痛风/高尿酸血症患者血清甲状腺激素及瘦素的变化

目的 探讨痛风/高尿酸血症（HUA）患者血清甲状腺激素及瘦素的变化.方法 选取2011年3月至2011年8月在天津医科大学代谢病医院痛风专科住院的原发性痛风96例（男87例,女9例）及HUA患者65例（男30例、女35例）及同期在体检中心健康体检者59例（男36例、女23例）.测定（1）血生化指标.（2）甲状腺功能.（3）空腹血糖（FPG）、空腹胰岛素（FINS）,空腹瘦素.结果 （1）痛风组和HUA组的亚临床甲减检出率分别为7.29％、15.38％,明显高于正常对照组（0）.（2）痛风及HUA组BMI、SBP、TG、总胆固醇（CHO）、促甲状腺激素（TSH）、FINS、胰岛素抵抗指数（HOMA-IR）、瘦素水平显著高于对照组,而游离甲状腺素（FT4）低于对照组（P＜0.05）.（3）以TSH为因变量,以性别、年龄、BMI、血清尿酸（SUA）、肌酐清除率（Ccr）、FT4为自变量作多元线性回归分析显示：女性、年龄、BMI、SUA、FT4、HOMA-IR、瘦素进入回归方程（β=-0.27、0.832、0.946、0.198、-0.942、0.895、0.650）.结论 原发性痛风/HUA患者亚临床甲减检出率明显升高,且女性高于男性.女性、年龄、BMI、SUA、FT4、HOMA-IR、瘦素是TSH升高的独立危险因素.胰岛素抵抗明显,瘦素水平高的痛风/高尿酸血症患者发生甲状腺功能低下的几率增加.

The change of thyroid hormones and leptin at hyperuricemia/gout

Objective To explore the change of thyroid hormones and leptin at hyperuricemia （HUA）/gout.Methods A total of 96 primary gouts,65 HUAs,and 59 healthy examiners was selected.Height,weight,blood pressure,renal function,serum uric acid（SUA）,glucose,lipid profiles,insulin,thyroid hormones were measured after an overnight fast.Results （1） The prevalence of subhypothyriodism at gout and HUA was 7.29% and 15.38%,respectively.They were higher than that at healthy subjects.（2） Body mass index （BMI）,systolic blood pressure （SBP）,triglyceride （TG）,cholesterol （CHO）,thyroid stimulating hormone （TSH）,fasting insulin （FINS）,homeostasis model assessment of insulin resistance （HOMA-IR）,and serum leptin level were increased remarkably at gout/hyperuricemia relative to control group,whereas,free thyroid hormone （FT4） was decreased.（4） In the gout and hyperuricemia groups,TSH was used as the dependent variable for the linear multivariate regression analysis,the results showed that sex,age,BMI,SUA,FT4,HOMA-IR,and Leptin were included in the regression equation of TSH （βwere-0.27,0.832,0.946,0.198,-0.942,0.895,and 0.650,respectively）.Conclusions The prevalence of subhypothyroidism in primary gout/hyperuricemia was increased.Female,age,BMI,SUA,FT4,HOMA-IR,and leptin were the independent risk factors.Insulin resistant and leptin played the media roles in the gout/HUA and hypothyroidism.