甲状腺功能紊乱女性患者治疗前后血清leptin和ghrelin水平的变化

Changes of serum leptin and ghrelin levels in dysthyroid women before and after treatment

目的探讨女性甲状腺功能紊乱患者治疗前、后血清leptin和ghrelin水平的变化。方法选择治疗前、后体脂稳定的21例初诊甲状腺功能亢进(甲亢)和17例甲状腺功能减退(甲减)女性患者,放射免疫分析法测定治疗前、后空腹血清leptin、ghrelin及甲状腺功能,计算体质量指数(BMI)和体脂百分数(%Fat),对照20例。结果 1.甲亢组治疗前空腹血清ghrelin水平(989.0±170.0)ng/L,明显低于对照组(1 205.0±338.0)ng/L(P<0.05);治疗后空腹血清ghrelin水平(1 236.0±179.0)ng/L,明显高于治疗前(P<0.01),且与对照组比较差异无统计学意义(P>0.05)。2.甲减组治疗前空腹血清ghrelin水平(1 537.0±251.0)ng/L明显高于正常对照组(1 205.0±338.0)ng/L(P<0.01),治疗后空腹血清ghrelin水平(1 253.0±370.0)ng/L明显低于治疗前(P<0.05),与对照组比较差异无统计学意义(P>0.05)。3.甲亢组和甲减组空腹leptin水平,治疗前、后与对照组比较差异无统计学意义。结论去除体脂因素后,提示BMI、%Fat并不是影响甲亢和甲减组治疗前空腹ghrelin及leptin水平变化的重要因素,且ghrelin可能参与了甲亢和甲减的发生、发展。

Objective To investigate the changes of serum leptin and ghrelin levels in dysthyroid women before and after treatment.Methods Leptin and ghrelin levels were determined by RIA in 21 cases of hyperthyroid and 17 cases of hypothyroid women with stable body mass index before and after the treatment,then the body mass index（BMI）,and percentage of body fat（%Fat）were calculated,20 comparable healthy adult served as control subjects.Results（1）In hyperthyroidism group,before treatment,serum ghrelin levels were lower（989.0±170.0）ng/L（P0.05）than those of the control subjects;after treatment,serum ghrelin levels increased（1 236.0±179.0）ng/L（P0.01） compared with those of the before treatmentand were similar to those in its control subjects（P 0.05）.（2） Serum ghrelin levels（1 537.0±251.0）ng/L in patients with hypothyroidism were higher than those of the control group（1 205.0±338.0）ng/L（P0.01）before treatment.After treatment,serum ghrelin levels significantly decreased（1 253.0±370.0）ng/L（P0.05） and had no significant difference compared to control group.3.Serum leptin concentrations in patients with hyperthyroidism or hypothyroidism were similar to those of control group before and after the treatment of hyperthyroidism or hypothyroidism.Conclusion Serum leptin and ghrelin levels is not associated with changes in BMI or %BF,ghrelin might play an important role in the pathogenesis and progress of hyperthyroidism or hypothyroidism before treatment.