毒性弥漫性甲状腺肿患者甲状腺激素与胆汁酸亚组分、血脂的关系

Relationship between thyroid hormones and bile acid subfractions and blood lipids in Graves'disease patients

目的探讨毒性弥漫性甲状腺肿(GD)患者甲状腺激素与胆汁酸亚组分、血脂的关系。方法选取2021年10月—2022年2月河北医科大学第一医院GD患者43例(GD组),以健康查体者36名作为正常对照组。检测所有研究对象6种初级胆汁酸[胆酸(CA)、鹅脱氧胆酸(CDCA)、甘氨胆酸(GCA)、甘氨鹅脱氧胆酸(GCDCA)、牛磺胆酸(TCA)、牛磺鹅脱氧胆酸(TCDCA)]、9种次级胆汁酸[脱氧胆酸(DCA)、熊脱氧胆酸(UDCA)、石胆酸(LCA)、甘氨脱氧胆酸(GDCA)、甘氨熊脱氧胆酸(GUDCA)、甘氨石胆酸(GLCA)、牛磺脱氧胆酸(TDCA)、牛磺石胆酸(TLCA)、牛磺熊脱氧胆酸(TUDCA)]、甲状腺功能[游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、高敏促甲状腺激素(hs-TSH)]和常规生化指标[空腹血糖(FBG)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)]。结果GD组与正常对照组之间hs-TSH、FT3、FT4、TC、HDL-C和LDL-C水平差异均有统计学意义(P<0.05),FBG、AST、ALT、TG水平差异均无统计学意义(P>0.05)。与正常对照组比较,GD组DCA、UDCA、GDCA、GUDCA、TUDCA显著降低(P<0.05),LCA、GLCA、TDCA、TLCA、CA、CDCA、GCA、GCDCA、TCA、TCDCA差异无统计学意义(P>0.05)。结论GD患者血清中部分胆汁酸亚组分和血脂水平发生改变,甲状腺功能状态与血脂和胆汁酸代谢存在一定的联系。

Objective To investigate the relationship between thyroid hormones and bile acid subfractions and blood lipids in patients with Graves'disease(GD).Methods Totally,43 patients with GD in the First Hospital of Hebei Medical University from October 2021 to February 2022(GD group)were enrolled,and 36 healthy subjects were used as healthy control group.Six primary bile acids[cholic acid(CA),chenodesoxycholic acid(CDCA),glycocholic acid(GCA),glycocholic chenodesoxycholic acid(GCDCA),taurocholic acid(TCA),taurochenodeoxycholic acid(TCDCA)],nine secondary bile acids[deoxycholic acid(DCA),ursodeoxycholic acid(UDCA),lithocholic acid(LCA),glycodeoxycholic acid(GDCA),glyco-ursodeoxycholic acid(GUDCA),glycine cholic acid(GLCA),tauro-deoxycholic acid(TDCA),taurocholic acid(TLCA),tauro-ursodeoxycholic acid(TUDCA)],thyroid function[free triiodothyronine(FT3),free thyroxine(FT4),high-sensitivity thyroid stimulating hormone(hs-TSH)]and biochemical parameters[fasting blood glucose(FBG),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),lowdensity lipoprotein cholesterol(LDL-C),aspartate aminotransferase(AST),alanine aminotransferase(ALT)]were determined.Results The differences in hs-TSH,FT3,FT4,TC,HDL-C and LDL-C levels between GD group and healthy control group were statistically significant(P<0.05),and the differences in FBG,AST,ALT and TG levels were not statistically significant(P>0.05).Compared with healthy control group,DCA,UDCA,GDCA,GUDCA and TUDCA were lower in GD group(P<0.05),and the differences in LCA,GLCA,TDCA,TLCA,CA,CDCA,GCA,GCDCA,TCA and TCDCA were not statistically significant(P>0.05).Conclusions The patients with GD have altered concentrations of some bile acid subfractions and blood lipids in serum.