甲状腺功能减退导致高甘油三酯血症的分子机制的新认识

A new sight into mechanism of hypertriglyceridemia induced by hypothyroidism

高甘油三酯血症是甲状腺功能减退症（甲减）的临床表现之一.促甲状腺素（thyroid stimulating hormone,TSH）除调节甲状腺激素轴外,还具有上调炎性细胞因子表达的作用.而炎性因子可促进小肠粘膜上皮细胞载脂蛋白B48（apolipoprotein B48）的合成,这提示TSH可能通过促发炎症而上调ApoB48表达;而理论上,低TH可抑制ApoB48合成.同时,由于Apol48是血清高甘油三酯血症的重要原因,上述矛盾难以解释甲状腺功能减退导致高甘油三酯的临床现象.因此,甲状腺功能减退可能是通过高TSH、低甲状腺激素水平影响ApoB48的表达,进而导致甘油三酯增高.

Hypertriglyceridemia is one of the clinical manifestations of hypothyroidism.Besides regulating thyroid hormone axis,thyroid stimulating hormone （TSH） also has the effect on up-regulated expression of inflammatory cytokines.Synthesis of inflammatory factors can promote the expression of apolipoprotein B48 （ApoB48） in intestinal mucosal epithelial cells,suggesting that TSH may up-regulate the expression of ApoB48 by inducing inflammation; while theoratically,low-level of thyroid hormones can inhibit the synthesis of ApoB48.At the same time,since ApoB48 is the important cause of hypertriglyceridemia,there is a contradiction that it is difficult to explain the clinical phenomenon of hypertriglyceridemia induced by hypothyroidism.Therefore,hypothyroidism may affect the expression of ApoB48 by high level of TSH and low level of thyroid hormones,leading to hypertriglyceridemia.