正常甲状腺功能人群血清促甲状腺素与血脂异常的相关性  

Correlation of serum thyroid-stimulating hormone with dyslipidemia in subjects with normal thyroid function

作　　者：胡颖[1] 时立新[1] 张巧[1] 彭年春[1] 

机构地区：[1]贵州医科大学附属医院内分泌代谢病科,贵阳550004

出　　处：《中华内分泌代谢杂志》2016年第1期15-18,共4页Chinese Journal of Endocrinology and Metabolism

基　　金：贵阳市科学技术计划项目[（2010）筑科农合同第1-社-20号、筑科农合同（201303）25号]

摘　　要：目的探讨血清促甲状腺素（TSH）与血脂异常的相关性。方法2009年10月至2010年2月在贵阳市宅吉社区整群随机抽取居民1512人，纳入1428人，详细填写流行病学调查问卷，测量身高、体重、腰围及血压，采集血样测定TSH、空腹血糖（FPG）、空腹胰岛素（FINS）和血脂水平。结果女性三酰甘油（TG）、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平亚临床甲减组较甲状腺功能正常组明显升高（P〈0．05），而男性2组间差异无统计学意义（P〉0．05）。甲状腺功能正常组TSH四分位Q1到Q4组，高TG血症的发生率分别为33．3％、35．5％、39．7％、44．0％，差异有统计学意义（P〈0．05），特别是女性及总人群中的TG水平随着TSH水平的升高而逐渐增加（P〈0．05），校正性别、年龄、体重指数（BMI）、稳态模型评估的胰岛素抵抗指数（HOMA—IR）后这种关系仍然存在（P〈0．05）。校正年龄、BMI、HOMA—IR后TSH水平与TG正相关（／3=0．064，P〈0．05）。结论即使在正常范围内TSH水平的升高也可能是血脂异常的危险因素。Objective To explore the relationship between serum thyroid-stimulating hormone （ TSH ） and dyslipidemia. Methods A total of 1 512 inhabitants in Zhaiji community of Guiyang urban areas were investigated from November 2009 to February 2010 by adopting stratified cluster sampling method, and 1 428 subjects were included in the present study. All subjects were asked to fulfill the questionnaires and to pass a physical examination. The vein blood samples were taken for determination of serum TSH, fasting plasma glucose （ FPG）, insulin, as well as blood lipid levels. Results Triglyceride （TG）, total cholesterol, high density lipoprotein cholesterol, and low density lipoprotein cholesterol levels were significantly increased in woman with subclinical hypothyroidism （SCH） compared to those with euthyroid （ all P〈0.05 ）. However, there was no significant difference in man between two groups （P〉0.05）. The incidences of hypertriglyceridemia in the euthyroid group from quartile 1 to quartile 4 of TSH were 33.3%, 35.5%, 39.7%, and 44.0% respectively （ P〈0.05 ）. Serum TG level was increased with TSH in woman and total subjects after adjustment for age, sex, body mass index （ BMI ）, waist-hip ratio （ WHR）, and homeostasis model assessment for insulin resistance index （ HOMA-IR, P〈0.05 ）. Serum TSH levels in the total sample were positively associated with TG after adjustment for age, sex, BMI, WHR, and HOMA-IR （β = 0. 088, P 〈 0.05 ）. Conclusion Higher serum TSH levels even within normal range seems to be a risk factor of dyslipidemia.

关 键 词：TSH 血脂异常 

分 类 号：R581[医药卫生—内分泌]