亚临床甲状腺功能减退症与高脂血症及非酒精性脂肪肝的相关性研究  

Association of subclinical hypothyroidism with dyslipidemia and non-alcoholic fatty liver

作　　者：谢玲玎[1] 高燕明[1] 卢桂芝[1] 蒋秋明[1] 郭晓蕙[1] 高妍[1] 

机构地区：[1]北京大学第一医院内分泌科,100034

出　　处：《中华内分泌代谢杂志》2006年第6期554-557,共4页Chinese Journal of Endocrinology and Metabolism

基　　金：北京大学"211工程"循证医学专业群资助项目(91000-246156057)

摘　　要：目的了解亚临床甲状腺功能减退症(甲减)与血清总胆固醇(TC)、甘油三酯(TG)水平及非酒精性脂肪肝的关系。方法对体检人群共1 602名成年人进行TSH、TT_3、TT_4测定。血清TC,TG水平及B型超声波诊断脂肪肝均采用同期或近期健康体检结果。男性和女性又划分为20～39岁、40～59岁及≥60岁的3个年龄组。结果(1)该人群总体亚临床甲减患病率为6．6%。(2)亚临床甲减人群TC、TG水平与正常人群相比差异无统计学意义(均P＞0．05)。(3)总体单因素比较亚临床甲减在TC升高人群的患病率高于正常人群,差异有统计学意义(P＜0．01)。(4)女性及男性各年龄组TC正常组及TC升高组亚临床甲减的患病率差异均无统计学意义(均P＞0．05)。多因素回归分析同样说明TSH水平不是TC升高的影响因素。(5)男性各年龄段TG升高组与TG正常组亚临床甲减的患病率差异均无统计学意义(均P＞0．05)。女性除高龄组(≥60岁)外各年龄段TG升高组均比TG正常组亚临床甲减的患病率高,组间差异同样无统计学意义(均P＞0．05),但多因素回归分析中TSH为TG升高的独立影响因素,相对危险度为1．102(P=0．03)。(6)分别校正血压、体重指数(BMI)及血糖后,脂肪肝人群亚临床甲减的患病率与非脂肪肝人群的患病率差异均无统计学意义。将影响非酒精性脂肪肝患病率的多种因素进行多因素回归分析,TSH水平非其独立影响因素(P＞0．05)。结论亚临床甲减与血清TC水平无显著相关,而可能引起血清TG水平增高；亚临床甲减似乎不会增加非酒精性脂肪肝的患病风险。Objective To investigate the prevalence of subclinical hypothyroidism and its relation to serum total cholesterol （TC）, triglyceride （TG） levels and non-alcoholic fatty liver. Methods Serum levels of TC, TG, TSH, TT3 and TT4 were determined in 1 602 subjects which were divided into groups by sex and age （20-39, 40- 59 and 360 years）. Fatty liver was diagnosed by type B ultrasonography. Results （ 1 ） Prevalence of subclinical hypothyroidism was 6. 6% in this population. （2） The mean levels of serum TC and TG in subclinical hypothyroidism group and normal group showed no significant difference （ beth P 〉 0.05 ）. （ 3 ） On the whole, the prevalences of subclinical hypothyroidism in hypercholesterolemia group and normal cholesterolemia group showed significant difference （P 〈0.01）. （4） In the three age groups of male and female examinees, the prevalenoes of subclinical hypothyroidism in hypereholesterolemia group and normal cholesterolemia group showed no significant difference （ all P 〉 0.05 ）. In the multiple regression analysis, TSH level was not related with raised TC level. （ 5 ） In the three age groups of male, there was no significant difference between the prevalenoes of subclinical hypothyroidism in hypertriglyeeridemia group and normal triglyceridemia group （ all P 〉 0.05 ）. In female, expect for the elderly group （ 〉 60 years old ）, the prevalence of subclinical hypothyroidism was higher in hypertfiglyoeridemia group than that in normal tfiglyoeridemia. However, in the multiple regression analysis, increased TSH level was positively associated with increased serum TG level （ OR = 1. 072, P =0. 013 and OR = 1. 102, P =0.03）. （6） The prevalence of subclinical hypothyroidism in non-alcoholic fatty liver group and normal group showed no significant difference （ P 〉 0. 05 ）. In the multiple regression analysis, TSH level was not the independent risk factor of non-alcoholic fatty liver （ P 〉 0. 05 ）. Conclusion Subclinical hypothyro

关 键 词：甲状腺功能减退症 亚临床 患病率 高胆固醇血症 高甘油三酯血症 脂肪肝 非酒精性 

分 类 号：R581.2[医药卫生—内分泌] R589.2[医药卫生—内科学] R575.5[医药卫生—临床医学]