无代谢综合征组分的体检人群人成纤维细胞生长因子21与促甲状腺激素的关系研究  

Relationship Between FGF21 and TSH in Healthy People Without Components of Metabolic Syndrome

作　　者：符天旭 苑姗姗[2] 高莹[2] 屈晨雪[3] 陈澜[2] 惠岩[2] 卢桂芝[2] 高燕明[2] 郭晓蕙[2] 

机构地区：[1]北京大学第一医院老年科,北京市100034 [2]北京大学第一医院内分泌科,北京市100034 [3]北京大学第一医院检验科,北京市100034

出　　处：《中国全科医学》2015年第36期4422-4427,共6页Chinese General Practice

基　　金：新世纪优秀人才支持计划(NCET-11-0003);北京市科技新星计划(2011011)

摘　　要：目的检测无代谢综合征组分的体检人群人成纤维细胞生长因子21（FGF21）水平、脂代谢、糖代谢相关指标及促甲状腺激素（TSH）水平,探讨FGF21与TSH的相关性。方法收集2012年10月—2013年4月北京大学第一医院体检人群中无任何代谢综合征组分,无糖尿病、高血压、慢性肾脏病、多囊卵巢综合征、自身免疫性疾病及垂体和下丘脑疾病病史者356例,记录年龄、性别,测量身高、体质量、腰围、臀围、血压、体脂含量,检测空腹血浆血肌酐（Scr）、尿酸（UA）、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）水平,检测空腹血清胰岛素（FINS）、TSH、甲状腺球蛋白抗体（Tg Ab）、甲状腺过氧化物酶抗体（TPOAb）、FGF21、游离脂肪酸（FFA）水平。计算体质指数（BMI）、腰臀比、稳态模型评估胰岛素抵抗指数（HOMA-IR）。结果 356例无代谢综合征组分者TSH 0.00~12.08 m U/L,其中TSH降低组（〈0.55 m U/L）8例,TSH正常组（0.55~4.78 m U/L）320例,TSH升高组（〉4.78 m U/L）28例;Tg Ab、TPOAb任一阳性组75例,Tg Ab和TPOAb均阴性组280例。FGF21 0~1 757 ng/L,FGF21水平与腰围（r=0.110,P=0.038）、腰臀比（r=0.119,P=0.025）、TC（r=0.113,P=0.012）、LDL-C（r=0.175,P=0.001）呈极弱正相关,FGF21水平与年龄（r=0.324,P〈0.001）、TG（r=0.302,P〈0.001）呈低度正相关。多元线性逐步回归分析结果显示,TG与FGF21独立相关（P〈0.001）,标准化回归方程为：Y_（FGF21）=230.84X_（TG）＋5.26X_（年龄）。TSH水平与Tg Ab（r=0.147,P=0.006）、TPOAb（r=0.168,P=0.001）呈极弱正相关;TSH水平与FFA（r=0.840,P〈0.001）呈高度正相关。TSH降低组、TSH正常组、TSH升高组FFA水平比较,差异有统计学意义（P〈0.05）;其中TSH正常组、TSH升高组FFA水平高于TSH降低组（P〈0.05）;TSH升高组FFA水平高于TSH正常组（P〈0.0Objective To measure FGF21 level,lipid metabolism,glycometabolism related indicators and TSH level and to investigate the correlation between FGF21 and TSH. Methods Enrolled 356 healthy subjects who received physical examination in Peking University First Hospital from October 2012 to April 2013 and were not detected with components of metabolic syndrome and had no history of diabetes mellitus, hypertension, chronic kidney diseases, polycystic ovarian syndrome,autoimmune disease,diseases of the hypothalamus and the pituitary gland. A series of data were recorded,including age,gender, measured height, body mass, waistline, hipline, blood pressure, Scr, UA, FBG, TG, TC, HDL- C,LDL- C,FINS,TSH, Tg Ab, TPOAb, FGF21 and FFA. BMI and HOMA- IR were calculated. Results TSH of the 356 subjects ranged from 0. 00 to 12. 08 mU / L,with 8 subjects of low TSH（ 0. 55 mU / L）,320 subjects of normal TSH（ 0. 55- 4. 78 mU / L） and 28 subjects of high TSH（ 4. 78 mU / L）; 75 patients were either Tg Ab positive or TPOAb positive,and280 patients were positive in both Tg Ab and TPOAb. When FGF21 was 0 ~ 1 757 ng / L, FGF21 level had very weak positive correlation with waistline（ r = 0. 110,P = 0. 038）,waist- hip ratio（ r = 0. 119,P = 0. 025）,TC（ r = 0. 113,P = 0. 012）and LDL- C（ r = 0. 175,P = 0. 001） and had low- degree correlation with age（ r = 0. 324,P〈0. 001） and TG（ r = 0. 302,P〈0. 001）. Multivariate linear regression analysis showed that TG had independent correlation with FGF21 with a standardized regression equation of Y_（FGF21）=230.84X_（TG）＋5.26X_（age）. TSH level had very weak positive correlation with Tg Ab（ r = 0. 147,P= 0. 006） and TPOAb（ r = 0. 168,P = 0. 001）; TSH level had high- degree positive correlation with FFA（ r = 0. 840,P〈0. 001）. Low TSH group,normal TSH group and high TSH group were significantly different in FFA level（ P〈0. 05）; normal TSH group and high TSH group were higher than low TSH group in FFA level（ P〈0. 05）; high TSH group

关 键 词：成纤维细胞生长因子 促甲状腺激素 自身免疫 脂肪酸类 非酯化 

分 类 号：R194.3[医药卫生—卫生事业管理]