不同病史抑郁患者血清促甲状腺激素和甲状腺激素与血脂水平的相关性

Low Serum Thyroid-stimulating Hormone Levels are Associated with Lipid Profile in Depressive Patients with Long Symptom Duration

目的探讨不同病史抑郁患者血清促甲状腺激素和甲状腺激素与血脂水平的相关性。方法共纳入年龄>18周岁抑郁患者400例,病史<3年为A组,病史≥3年为B组,入院前所有患者接受障碍定式临床检测(SCID)并同时记录患者病史,检测患者血清中总胆固醇(TCH)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、脂蛋白A[Lp(a)]、超敏C反应蛋白(hs-CRP)、游离甲状腺素(FT_4)、游离三碘甲腺原氨酸(FT_3)和促甲状腺激素(TSH)的水平,并计算TCH/HDL-C比值。结果 B组患者血清中TG和TCH/HDL-C比值相对于A组患者显著升高,而HDL-C、FT_4和TSH水平则相对于A组患者显著降低,差异均有统计学意义(P<0.05)。相关性分析表明TSH水平与TCH和LDL-C水平呈明显的正相关,FT_4水平与TCH/HDL-C比值呈明显的负相关,FT_3水平与TCH、HDL-C和LDL-C水平也分别表现出明显的负相关;多重线性回归分析表明血清TG和TSH水平与抑郁患者发病史相关。结论抑郁患者血清中低的TSH水平与脂质代谢紊乱相关,并且TG和TSH水平与患者的抑郁症病史也呈明显相关性。

Objective To investigate the association between serum thyroid hormones and thyroid-stimulating hormone levels with lipid profile in depressive disorder.Methods A total of 400 depressive individuals aged 18 years and above were recruited in this cross-section study.And all patients were divided into two group：A group（subjects with a symptom duration3 years）,B group（subjects with a symptom duration≥3 years）.All participants underwent a Structured Clinical Interview for DSM-IV（SCID）and recorded the duration of their symptoms.The serum levels of total cholesterol（TCH）,triglyceride（TG）,high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol（LDL-C）,lipoprotein A[Lp（a）],high-sensitivity Creactive protein（hs CRP）,free thyroxine（FT4）,free triiodothyronine（FT3）and TSH levels were determined and the ratios of TCH/HDL-C were assessed.ResultsB group had higher TG levels,increased TCH/HDL-C ratios and lower levels of HDL-C,FT4and TSH compared with A group.Correlation analysis displayed that TSH was positively and significantly associated with TCH and LDL-C.The above FT4and FT3were negatively,significantly and respectively associated with TCH/HDL-C and TCH,HDL-C,LDL-C.Multiple linear regression analysis indicated that serum TG and TSH levels were associated with depressive symptom duration.Conclusion Our results indicate that low serum TSH levels are associated with lipid profile.TG and TSH levels have significant association with symptom duration in depressive patients.