甲状腺功能减退症及亚临床甲状腺功能减退症患者的血脂变化研究

Research on lipid changes in patients with hypothyroidism and subclinical hypothyroidism

目的观察甲状腺功能减退症(甲减)及亚临床甲状腺功能减退症(亚甲减)患者血脂的状况,并分析亚甲减患者促甲状腺素(TSH)值与血脂间的关系。方法收集2011年1月至2014年6月在我院内分泌科门诊及病房就诊的甲减患者(甲减组)133例、亚临床甲减患者(亚甲减组)146例,并收集同期在我科门诊或病房检查甲状腺功能正常者86例作为对照组,比较各组血脂的变化;将亚甲减组按TSH分层分为亚甲减-1组、亚甲减-2组,并与对照组比较。结果甲减组总胆固醇(CHO)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)高于对照组,高密度脂蛋白胆固醇(HDL-C)低于对照组,差异均有统计学意义(P<0.05);亚甲减组CHO、LDL-C均明显高于对照组,差异有统计学意义(P<0.05);分层后,亚甲减-1组CHO与对照组比较有升高趋势,但差异无统计学意义(P>0.05),TSH>10μU/L亚甲减组CHO、TG、LDL-C均明显高于对照组,差异有统计学意义(P<0.05)。结论甲减及亚甲减患者血脂明显升高,且亚甲减-2组患者血脂升高与TSH值升高有关,临床应予重视。

Objective To observe lipid levels in patients with hypothyroidism and subclinical hypothyroidism and also to analyze the relationship between thyroid-stimulating hormone（ TSH） and lipid level in patients with subclinical hypothyroidism. Methods One hundred and thirty-three patients with hypothyroidism and 146 patients with subclinical hypothyroidism,who sought medical care from January 2010 to June 2014 in the outpatient and inpatient departments of the hospital were respectively assigned as the hypothyroidism group and the subclinical hypothyroidism group. Another 86 examinees,who sought medical advice during the same period,but with normal thyroid function,were used as the control group. Changes in lipid levels were compared between the groups. The subclinical hypothyroidism group was further divided into the subclinical hypothyroidism group 1 and group 2 in accordance with TSH levels,and then they were compared with the normal control group. Results For the hypothyroidism group,the levels of total cholesterol,triglyceride（ TG） and low-density lipoprotein cholesterol（ LDL-C） were higher than those of the control group,while the level of high-density lipoprotein cholesterol（ HDL-C） was lower than that of the control group,and statistical significance could be seen,when comparisons were made between them（ P〈0. 05）. For the subclinical hypothyroidism group,the levels of total cholesterol and LDL-C were all significantly higher than those of the control group,with statistical difference（ P〈0. 05）. The level of total cholesterol of the subclinical hypothyroidism group 1 tended to increase,as compared with that of the control group,but without statistical significance（ P〉0. 05）. For the subclinical hypothyroidism group 2,the levels of total cholesterol,TG and LDL-C were all significantly higher than those of the control group,also with statistical significance（ p 〈0. 05）. Conclusion The levels of lipid in patients with hypothyroidism and subclinical hypothyroidism significantly increased,and the lipid increase in the patients of the subclinical hypothyroidism group 2was correlated with the increase of TSH level,to which attention must be paid clinically.