先天性甲状腺功能减低症患儿治疗前后血清ghrelin的动态变化

Dynamic Changes of Serum Ghrelin in Children with Congenital Hypothyroidism before and after Treatment

目的观察甲状腺素替代治疗对先天性甲状腺功能减低症(CH)患儿血清ghrelin水平的影响。方法研究对象为2007年10月-2008年3月在徐州医学院附属医院确诊并行治疗随访的CH患儿40例及健康体检儿童30例。分组:未治疗组包括甲状腺功能减低的CH患儿20例;治疗组包括新诊断或随访中经甲状腺素片治疗后甲状腺功能正常至少1个月的CH患儿20例;健康对照组年龄、性别相当的健康儿童30例。采用夹心法酶联免疫吸附试验测定3组儿童血清ghrelin水平,采用化学发光法测定三碘甲状腺原氨酸(T3)、四碘甲状腺原氨酸(T4)、促甲状腺激素刺激激素(TSH)水平,同时计算每个样本的体质量指数(BMI)用于相关分析。结果 1.未治疗组ghrelin水平[(2.35±0.23)μg·L-1]虽高于治疗组[(2.16±0.25)μg·L-1]和健康对照组[(1.96±0.27)μg·L-1],但差异无统计学意义(P=0.102)。2.Ghrelin与年龄呈负相关(r=-0.325,P<0.05),但与性别、BMI、T3、T4、TSH无相关关系(Pa>0.05)。结论甲状腺激素对中枢或外周ghrelin的产生和分泌可能无调控作用。在不同生长发育时期,不同水平的ghrelin可能有不同的生理作用。

Objective To investigate the effect of thyroxine replacement therapy on the serum ghrelin level in pediatric patients with congenital hypothyroidism（CH）.Methods A total of 70 children were divided into 3 groups.Twenty CH children with thyroid hypofunction were defined as untreated group,20 cases of CH children with at least 1 month of euthyroidism after treatment were cataloged into treatment group,and the other 30 healthy children matched with age and gender were assigned as the healthy control group.Serum ghrelin levels of each subject were determined by enzyme linked immunosorbent assay（ELISA）.Chemiluminescence method was used to detect the levels of serum triiodothyronine（T3）,thyroxine（T4）,thyrotropic-stimulating hormone（TSH）.Body mass index（BMI） of each subject was also calculated and analyzed by the correlation analysis.Results 1.Ghrelin level in untreated group[（2.35±0.23） μg·L-1] was higher than that in treatment group[（2.16±0.25） μg·L-1] and healthy control group[（1.96±0.27） μg·L-1],however,the differences did not reach the statistic significance（P0.05）.2.The negative correlation was found between ghrelin and age（r=-0.325,P0.05）;No correlation were observed among ghrelin and BMI,T3,T4,TSH,gender（Pa0.05）.Conclusions It can not inferred that thyroid hormone has regulatory effect on the central or peripheral ghrelin production and secretion.Ghrelin may play different physiological roles at different growth stages of man.