甲亢患者血清CTRP3、CTRP9与甲状腺激素水平及动脉粥样硬化的关系

Relationships between serum CTRP3,CTRP9 and thyroid hormone levels,atherosclerosis in patients with hyperthyroidism

目的检测甲亢患者血清脂肪因子补体C1q肿瘤坏死因子相关蛋白3(CTRP3)和CTRP9及甲状腺激素水平,并分析其与动脉粥样硬化(AS)的关系。方法选取2016年6月-2018年6月琼海市人民医院收治的甲亢患者124例为研究对象,根据彩色多普勒超声结果将患者分为AS组56例,非AS组患者68例,选取本院同期健康体检者100例为对照组。采用酶联免疫吸附法(ELISA)检测血清CTRP3、CTRP9水平,利用全自动生化分析仪检测空腹血糖(FBG)、甘油三酯(TG)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL)、高密度脂蛋白胆固醇(HDL)水平;检测患者入院收缩压(SBP)、舒张压(DBP);利用彩色多普勒超声仪检测左室射血分数(LVEF)。结果与对照组比较,AS组、非AS组甲亢患者血清FBG、FT3、FT4水平升高,非AS组BMI指数、TC、TG、LDL、HDL、TSH及CTRP3、CTRP9水平显著降低,差异有统计学意义(P<0.05),AS组BMI指数、TC、HDL、TSH及CTRP3、CTRP9水平显著降低,差异有统计学意义(P<0.05)。与非AS组甲亢患者比较,AS组患者血清FBG、TC、TG、LDL、FT3、FT4水平升高,TSH及CTRP3、CTRP9水平显著降低,差异有统计学意义(P<0.05)。合并AS甲亢患者血清CTRP3、CTRP9水平与FT3、FT4水平显著负相关(P<0.05),与TSH水平显著正相关(P<0.05);ROC分析结果表明,血清CTRP3、CTRP9水平对甲亢患者发生AS均具有一定预测价值,二者联合诊断的灵敏度为87.50%,特异度为82.40%,AUC为0.908,具有较高诊断价值。结论甲亢患者血清CTRP3、CTRP9水平降低,与FT3、FT4显著负相关,与TSH水平显著正相关,二者联合检测对甲亢患者发生AS具有较高诊断价值。

Objective To detect the levels of serum adipokine complement C1q tumor necrosis factor⁃related protein(CTRP)3,CTRP9 and thyroid hormone in patients with hyperthyroidism,and analyze their relationships with atherosclerosis(AS).Methods 124 patients with hyperthyroidism admitted to our hospital from June 2016 to June 2018 were selected as the research objects.According to the results of color Doppler ultrasound,the patients were divided into AS group(56 cases)and non⁃AS group(68 cases).Another 100 healthy people in our hospital during the same period were selected as the control group.The levels of serum CTRP3 and CTRP9 were detected by ELISA.The levels of fasting blood glucose(FBG),triglyceride(TG),cholesterol(TC),low density lipoprotein cholesterol(LDL)and high density lipoprotein cholesterol(HDL)were detected by automatic biochemical analyzer.Systolic blood pressure(SBP)and diastolic blood pressure(DBP)were measured.Left ventricular ejection fraction(LVEF)was measured by color Doppler ultrasound.Results Compared with the control group,the levels of serum FBG,FT3 and FT4 increased in AS group and non⁃AS group,while BMI index,TC,TG,LDL,HDL,TSH,CTRP3 and CTRP9 decreased significantly in the non⁃AS group(P<0.05).The levels of BMI index,TC,HDL,TSH,CTRP3 and CTRP9 decreased significantly in AS group(P<0.05).Compared with non⁃AS hyperthyroidism patients,the levels of serum FBG,TC,TG,LDL,FT3 and FT4 in AS patients increased,while the levels of TSH,CTRP3 and CTRP9 decreased significantly(P<0.05).Serum CTRP3 and CTRP9 levels were negatively correlated with FT3 and FT4 levels in patients with AS hyperthyroidism(P<0.05),and positively correlated with TSH level(P<0.05).The results of ROC analysis showed that serum CTRP3 and CTRP9 levels had certain predictive values for AS in patients with hyperthyroidism,and the sensitivity,specificity and AUC of combined diagnosis were 87.50%,82.40%and 0.908,respectively,which had high diagnostic value.Conclusion The levels of serum CTRP3 and CTRP9 in patients with hyperthyroidism were significantly decreased,which were negatively correlated with FT3 and FT4,and positively correlated with TSH.The combined detection of CTRP3 and CTRP9 has high diagnostic value for AS in patients with hyperthyroidism.