甲状腺功能减退症患者血清脂质转移蛋白活性检测的价值

Role of serum lipid transfer protein activity determination in patients with hypothyroidism

目的探讨甲状腺功能减退症(简称甲减)患者血清脂质转移蛋白活性检测的价值。方法选取86例甲减患者,以86名体检健康者作为正常对照组。收集所有对象的一般资料[性别、年龄、吸烟史、饮酒史、体质量指数(BMI)],检测血脂[总胆固醇(TC)、三酰甘油(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、非高密度脂蛋白胆固醇(non-HDL-C)]水平及血清胆固醇酯转运蛋白(CETP)和磷脂转运蛋白(PLTP)活性。采用多元线性回归分析评价甲减与血脂及脂质转移蛋白的关系。结果 与正常对照组比较,甲减组血清HDL2-C水平、HDL2-C/HDL3-C比值及CETP、PLTP活性降低(P<0.01),HDL3-C水平升高(P<0.01),而2个组之间血清TC、TG、LDL-C、HDL-C和non-HDL-C水平差异无统计学意义(P>0.05)。CETP与HDL2-C呈正相关(r=0.27,P<0.001),与HDL3-C、TSH均呈负相关(r值分别为-0.22、-0.21,P<0.01);PLTP与HDL2-C呈正相关(r=0.37,P<0.001),与HDL3-C、TSH呈负相关(r值均为-0.24,P<0.001)。TSH与HDL2-C、HDL3-C无相关性(r值分别为-0.291、0.012,P>0.05)。调整年龄、性别、BMI、吸烟史和饮酒史后的多元线性回归分析显示,CETP、PLTP与甲减有关(β值分别为0.62、0.81,P<0.001),与血脂无关(P>0.05)。结论 甲减患者HDL2-C降低和HDL3-C升高可能与脂质转运蛋白活性下降有关,这些指标或许可作为甲减患者脂质紊乱的早期生物标志物。

Objective To investigate the role of serum lipid transfer protein activity determination in patients with hypothyroidism. Methods A total of 86 patients with hypothyroidism and 86 healthy subjects were enrolled. The general data [sex,age,smoking history,drinking history and body mass index(BMI)] were collected. Total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C) and non-high-density lipoprotein cholesterol(non-HDL-C) levels and serum cholesterol ester transporter(CETP) and phospholipid transporter(PLTP) activities were determined. Multiple linear regression analysis was used to evaluate the relationship of hypothyroidism with blood lipids and lipid transfer proteins. Results Compared with healthy control group,serum HDL2-C level,HDL2-C/HDL3-C ratio,CETP activity and PLTP activity decreased(P<0.01),HDL3-C level increased(P<0.01),and there was no statistical significance in serum TC,TG,LDL-C,HDL-C and non-HDL-C between the 2 groups(P>0.05). CETP was positively correlated with HDL2-C(r=0.27,P<0.001),and it was negatively correlated with HDL3-C and thyroid stimulating hormone (TSH)(r=-0.22 and -0.21,P<0.01). PLTP was positively correlated with HDL2-C(r=0.37,P<0.001), and it was negatively correlated with HDL3-C and TSH(r=-0.24,P<0.001). There was no correlation of TSH with HDL2-C and HDL3-C(r=-0.291 and 0.012,P>0.05). Multiple linear regression analysis after adjusting for age, sex,BMI,smoking history and drinking history showed that CETP and PLTP were correlated with hypothyroidism (β=0.62 and 0.81,P<0.001),and they were not correlated with blood lipids(P>0.05). Conclusions The decrease of HDL2-C and the increase of HDL3-C in patients with hypothyroidism are related to the decrease of lipid transfer protein activity. These may be early biomarkers of lipid disorders in patients with hypothyroidism.