甲状腺功能亢进症患者治疗前后血浆Ghrelin水平的变化

Changes of plasma ghrelin in patients with hyperthyroidism during treatment

目的了解甲状腺功能亢进症患者治疗前后血浆Ghrelin水平的改变。方法测定甲状腺功能亢进组患者治疗前后和对照组的血浆Ghrelin水平,分析血浆Ghrelin与血清游离T3(FT3)、游离T4(FT4)、促甲状腺激素(S-TSH)、空腹血糖(FPG)的相关性。结果甲状腺功能亢进组经他巴唑治疗1个月后,FT3、FT4及FPG均较治疗前有明显降低,而Ghrelin、体质量指数(BMI)明显升高,差异均有统计学意义(t分别=3.87、4.49、3.16、2.89、3.27,P均<0.05);且治疗2个月后,FT4、Ghrelin、BMI均明显高于治疗1个月时的水平,差异均有统计学意义(t分别=2.27、4.05、3.22,P均<0.05)。相关性分析表明血浆Ghrelin水平与FT4、FT3浓度呈明显呈负相关,差异均有统计学意义(r分别=-0.38、-0.42,P均<0.05),而与S-TSH明显呈正相关,差异有统计学意义(r=0.30,P均<0.05)。结论甲状腺功能亢进患者的负氮平衡同时伴随着血清Ghrelin水平降低,甲状腺激素可能对中枢或外周Ghrelin的产生和分泌具有直接的调控作用。

Objective To study the changes and clinical value of ghrelin in patients with hyperthyroidism during treatment. Method The plasma levels of ghrelin were measured in patients with hyperthyroidism and healthy subjects as control group. The level of ghrelin was analyzed with the level of free triiothyronine （FT3）, free thyroxine （FT4）, S-thyroid-stimulating hormone （S-TSH） and free glucose （FPG）. Results The FT3, FT4 and FPG of the patients with hyperthyroidism were lower than that before treatment with statistic significance （t=3.87,4.49,3.16, P〈0.05）. The ghrelin and BMI were higher than that before treatment with statistic significance （t=2.89,3.27, P〈0.05）. The FT4, ghrelin and BMI after treatment for two months were higher than that after treatment for one month with statistic significance （t=2.27, 4.05, 3.22, P〈0.05）. The correlation analysis showed that the level of ghrelin was negatively correlated with FT4, FT3 with statistic significance （r=-0.38,-0.42, P〈0.05） and positively correlated with S-TSH with statistic significance （t=-0.30, P〈0.05）. Conclusions The negative nitrogen balance of patients with hyperthyroidism has lower level of ghrelin. The thyroid hormone may have direct regulation on the production and secretion of central or periphery ghrelin.