甲状腺功能减退症患者血尿酸变化及相关因素分析  

Serum uric acid change and related factors analysis in hypothyroidism patients

作　　者：李明[1] 赵青松[1] 许金梅[1] 唐莹莹[1] 夏楠[1] 王明丽[1] 杜丽莉[1] 康英英[1] 王海萍[1] 成志锋[1] 

机构地区：[1]哈尔滨医科大学附属第四医院内分泌科,黑龙江省哈尔滨150001

出　　处：《中国慢性病预防与控制》2015年第9期646-648,共3页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：黑龙江省卫生和计划生育委员会科研课题(2013104)

摘　　要：目的探讨甲状腺功能减退患者血尿酸水平的变化及相关影响因素。方法选取甲状腺功能减退患者155例作为病例组,健康体检者159例作为对照组,记录两组的一般资料、血液生化指标、尿尿酸指标等。结果与对照组相比,甲状腺功能减退组舒张压、总胆固醇、甘油三酯、血尿酸和促甲状腺激素(TSH)水平较高,尿尿酸、游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)水平较低,差异均有统计学意义(P<0.01);血尿酸水平与各指标的相关分析结果显示,血尿酸水平与体质指数(BMI)、舒张压、甘油三酯、血肌酐、丙氨酸氨基转移酶、TSH呈显著正相关(r值分别为0.182、0.145、0.145、0.257、0.114和0.519,P<0.05),与空腹血糖、尿尿酸、FT3、FT4呈显著负相关(r值分别为-0.143、-0.382、-0.397和-0.415,P<0.05)。在调整年龄、BMI、舒张压、总胆固醇、甘油三酯、空腹血糖和尿尿酸后,多元逐步回归提示,血尿酸与TSH、血肌酐、丙氨酸氨基转移酶、FT4相关。结论甲状腺功能减退是高尿酸血症的危险因素,甲状腺功能减退症致高尿酸血症的机制可能是肾脏尿酸排泄减少。Objective To investigate the changes of serum uric acid levels and related factors in patients with hypothyroidism. Methods The subjects were divided into case group （155 patients with hypothyroidism） and control group （159 healthy controls ）. The data of general information, blood biochemical indicators, urinary uric acid levels were collected for all subjects. Results As compared with the control group, the diastolic blood pressure, total cholesterol, triglyceride, serum uric acid, thyroid stimulating hormone （TSH） levels increased significantly, and urinary uric acid, free triiodothyronine （FT3）, free thyroxine （FT4） levels decreased significantly （P〈0.01）. Correlation analysis showed that there was positive correlation between level of serum uric acid and BMI, diastolic blood pressure, triglyceride, serum creatinine, alanine transarninase （ALT） or TSH （r values were 0.182, 0.145, 0.145, 0.257, 0.114 and 0.519, respectively, P〈O.05 ）. But there was negative correlation between level of fasting glucose, urinary uric acid, FT3 or FT4 （r values were -0.143,-0.382,-0.397 and -0.415, respectively, P〈0.05 ）. After adjusting age, BMI, diastolic blood pressure, TC, TG, fasting glucose and urinary uric acid, multivariate regression analysis suggested that the serum uric acid was associated with TSH, creatinine, ALT and FT4. Conclusion Hypothyroidism is a risk factors of hyperuricemia and the mechanism of hyperuricemia induced by hypothyroidism may be the reduction of renal uric acid excretion.

关 键 词：甲状腺功能减退 高尿酸血症 促甲状腺素 

分 类 号：R581.2[医药卫生—内分泌]