甲状腺功能与血清饥饿素和瘦素水平的相关性研究

Association of thyroid function with human serum ghrelin and leptin levels

目的观察甲状腺功能亢进症（甲亢）、甲状腺功能减退症（甲减）及正常人血清饥饿素和瘦素水平，并探讨它们与甲状腺功能的关系。方法采用放射免疫分析法分别检测46例未接受治疗甲亢患者（甲亢A组）、15例^131I治疗有效的甲亢患者（甲亢B组）、21例甲减患者和18例正常对照者血清饥饿素及瘦素水平，同时采用全自动化学发光免疫分析法检测血清游离三碘甲腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺素（SH）水平。结果（1）甲亢A组的血清饥饿素水平明显低于甲亢B组（t=3．21，P〈0．01）、甲减组（t=3．02，P〈0．01）和正常对照组（t=3．39，P〈0．01）；甲亢B组、甲减组和正常对照组之间的血清饥饿素水平比较无显著差异。（2）甲亢A组血清瘦素水平与甲亢B组、甲减组和正常对照组比较无显著差异；甲亢B组、甲减组和正常对照组之间的血清瘦素水平比较无显著差异。（3）血清饥饿素水平与血清FT3（r=-0．29；P〈0．05）和FT4（r=-0．26，P〈0．05）呈负相关，与TSH呈正相关（r=0．36，P〈0．05）；血清瘦素水平与血清FT3、FT4和TSH无显著相关性。结论血清饥饿素水平在不同甲状腺功能状态下不同，并与甲状腺激素水平有一定的相关性，而血清瘦素无此作用。

Objective To investigate the effect of different status of thyroid function （ hypothyroidism and hyperthyroidism as well as euthyroid status） on serum ghrelin and leptin levels. Methods The levels of serum ghrelin and leptin were determined by radio immunoassay in 46 untreated subjects with hyperthyroidism, 15 hyperthyroid patients achieved a euthyroid status after radioiodine ^131I therapy, 21 cases of hypothyroidism and 18 cases of normal controls, respectively. Meanwhile, the serum levels of free triiodothyronine （FT3）, free thyroxine （FT4） and thyroid-stimulating hormone （TSH） were measured by chemiluminescence immune assay. Results （1） The levels of serum ghrelin in untreated hyperthyroidism were significantly lower than those in hyperthyroid patients achieved a euthyroid status （t=3.21, P〈0.01） , hypothyroidism （t=3.02, P〈0.01） and the normal groups （t=3.39, P〈0.01）, but the levels of serum ghrelin in hypothyroidism patients were similar to those in normal groups; （2） The levels of serum leptin did not differ; （3） Serum ghrelin levels were negatively correlated with FT3 （r=-0.29, P〈0.05） and FT4 （r=-0.26, P〈 0.05）, positively correlated with serum TSH （r=0.36, P〈0.05） ; serum leptin levels did not correlate with thyroid hormone. Conclusion The levels of serum ghrelin were differently under different thyroid functional status and correlated with thyroid hormone, while serum leptin were not.