不同甲状腺功能状态血清胃促生长素水平的变化

Serum ghrelin levels in different thyroid functional status

探讨不同甲状腺功能状态下血清胃促生长素水平的变化及其与体重指数、腰臀比、甲状腺功能、血糖、胰岛素及胰岛素抵抗的关系。初诊甲状腺功能亢进症（甲亢）患者50例及甲状腺功能减退症（甲减）患者30例，测定其治疗前及甲状腺功能恢复正常后空腹血清胃促生长素、胰岛素、血糖、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）和促甲状腺激素（TSH）水平，同时测量身高、体重、腰围、臀围，计算体重指数、腰臀比、稳态模型评估的胰岛素抵抗指数（HOMA—IR）等，以健康对照者30例为对照。甲亢患者治疗前血清胃促生长素水平低于正常对照组[（63．2±9．6）ng／L对（80．9±13．9）ng／L，P〈0．01]，经多元逐步回归分析提示HOMA—IR是胃促生长素的独立影响因素（r=-0．314，P=0．027）。甲状腺功能减退症患者，治疗前后胃促生长素水平和正常对照组比较均无明显差异（均P〉0．05）。本研究提示，在不同甲状腺功能状态下，胰岛素抵抗可能是胃促生长素水平改变的重要影响因素。

To investigate the changes of serum ghrelin levels and their relationship with body mass index （BMI）,waist-to-hip ratio （WHR）, thyroid function, blood glucose, insulin, and insulin resistance parameters in different thyroid functional status. The fasting serum ghrelin, insulin, glucose, and thyroid hormone levels were determined, BMI, WHR, and homeostasis model assessment for insulin resistance index（HOMA-IR） were calculated in 50 hyperthyroid and 30 hypothyroid patients at diagnosis and after normalization of thyroid function. 30 euthyroid subjects served as control. The ghrelin levels in hyperthyroid patients before treatment were lower than that in control group [ （63.2 ±9.6 ） ng/L vs （ 80.9 ± 13.9 ） ng/L, P〈0.01 ]. Multiple regression analysis showed that HOMA-IR was an independent factor related to fasting ghrelin levels （r =-0. 314, P = 0. 027 ）. The ghrelin levels were similar in hypothyroid patients and the controls before and after the treatment. It suggests that insulin resistance might be an important factor in regulating serum ghrelin levels in different thyroid functional status.