甲状腺功能亢进症患者血清FGF21表达及其与FT3、FT4水平的关系

Expression of serum fibroblast growth factor 21 in patients with hyperthyroidism and its relationships with triiodothyronine and free thyroxine levels

目的探究甲状腺功能亢进症(简称"甲亢")患者血清成纤维细胞生长因子21 (FGF21)的表达及其与游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平的关系。方法选取2016年8月至2017年8月于西电集团医院内分泌科收治的甲亢患者68例为观察组,另取同期于本院体检的健康人员47例为对照组,检测两组受检者的血脂、促甲状腺激素(TSH)、血清FGF21、FT3、FT4水平,分析FGF21表达与FT3、FT4水平间关系,并应用多因素logistic回归分析探究影响FGF21表达的因素。结果两组受检者的总胆固醇(TG)与甘油三酯(TC)比较,差异均无统计学意义(P>0.05);观察组患者的高密度脂蛋白胆固醇(HDL-C)为(1.57±0.21) mmol/L,明显高于对照组的(1.39±0.18) mmol/L,低密度脂蛋白胆固醇(LDL-C)、TSH分别为(2.23±0.45) mmol/L、(0.02±0.01) mIU/L,明显低于对照组的(2.51±0.48) mmol/L、(2.02±0.23) m IU/L,差异均有统计学意义(P<0.05);观察组患者的FGF21为(151.38±24.96) pg/mL,明显低于对照组的(213.72±29.51) pg/mL,FT3、FT4分别为(12.14±4.27) pmol/mL、(29.65±4.78) pmol/mL,明显高于对照组的(4.96±0.68) pmol/mL、(20.27±3.59) pmol/mL,差异均有统计学意义(P<0.05);血清FGF21表达均与FT3、FT4呈显著负相关(r=-0.650、-0.324,P<0.05);多因素Logistic回归分析结果显示,年龄、TSH、FT4是影响FGF21表达的独立因素(P<0.05)。结论甲亢患者血清FGF21呈低水平表达,与FT3、FT4呈显著负相关,且年龄、TSH、FT4可影响FGF21表达水平,其在甲亢疾病发生发展过程中起重要作用。

Objective To investigate the expression of serum fibroblast growth factor 21(FGF21) in patients with hyperthyroidism and its relationships with the levels of free triiodothyronine(FT3) and free thyroxine(FT4).Methods A total of 68 patients with hyperthyroidism, who admitted to Department of Endocrinology of Xidian Group Hospital from August 2016 to August 2017, were selected as the observation group. Another 47 healthy persons who received physical examination in the same period were selected as the control group. The levels of serum lipids, thyroid stimulating hormone(TSH), serum FGF21, FT3, and FT4 in the two groups were detected, the relationships between FGF21 expression with FT3 and FT4 levels were analyzed, multivariate logistic regression analysis was used to explore the factors influencing the FGF21 expression level. Results There was no significant difference in total cholesterol(TG) and triglyceride(TC) between the two groups(P>0.05);the high density lipoprotein cholesterol(HDL-C) in the observation group was(1.57±0.21) mmol/L, which was significantly higher than(1.39±0.18) mmol/L in the control group,the low density lipoprotein cholesterol(LDL-C) and TSH were(2.23±0.45) mmol/L,(0.02±0.01) mIU/L, respectively,which were significantly lower than corresponding(2.51±0.48) mmol/L and(2.02±0.23) mIU/L in the control group(all P<0.05);the FGF21 in the observation group was(151.38±24.96) pg/mL, which was significantly lower than(213.72±29.51) pg/mL in the control group, FT3 and FT4 were(12.14 ± 4.27) pmol/mL,(29.65 ± 4.78) pmol/mL, respectively,which were significantly higher than corresponding(4.96 ± 0.68) pmol/mL and(20.27 ± 3.59) pmol/mL in the control group(all P<0.05);the expression of serum FGF21 was negatively correlated with FT3 and FT4(r=-0.650,-0.324, P<0.05);multivariate logistic regression analysis showed that age, TSH and FT4 were independent factors affecting the expression of FGF 21(P<0.05). Conclusion The expression of serum FGF21 is low in patients with hyperthyroidism,which is negatively correlated with FT3 and FT4. Age, TSH, and FT4 can affect the level of FGF21 expression. FGF 21 plays an important role in the occurrence and development of hyperthyroidism.