甲亢患者血清瘦素脂联素水平与甲状腺激素和骨代谢指标的关系  

The Relationship between Serum Leptin and Adiponectin Levels with Thyroid Hormone and Bone Metabolism in Patients with Hyperthyroidism

作　　者：张弢[1] 于扬[1] 隋淼[1] 许静宜[1] 杨晓辉[1] ZHANG Tao;YU Yang;SUI Miao(Zhongshan Hospital Affiliated to Dalian University,Liaoning Dalian 116001,China)

机构地区：[1]大连大学附属中山医院内分泌一科

出　　处：《河北医学》2020年第1期28-33,共6页Hebei Medicine

基　　金：辽宁省自然科学基金项目,(编号:2018020153)

摘　　要：目的: 比较分析甲亢患者血清瘦素、脂联素水平变化及其与甲状腺激素水平及骨代谢指标的关系。 方法: 选取2018年4月至2019年3月本院诊治的78例甲亢患者为甲亢组,同时选取本院健康体检正常志愿者56例为对照组。同时根据甲亢患者是否发生骨质疏松分为骨质疏松组(21例)与非骨质疏松组(57例)。采用放射免疫法检测血清瘦素水平;采用酶联免疫吸附法(ELISA)检测血清脂联素水平。采用化学发光法检测血清甲状腺激素指标三碘甲状腺原氨酸(T3)、四碘甲状腺原氨酸(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、甲状旁腺素(PTH)、促甲状腺激素(TSH)水平。采用ELISA法检测骨代谢相关细胞因子白细胞介素-6(IL-6)、肿瘤坏死因子(TNF)、降钙素(CT)、胰岛素样生长因子-Ⅱ(IGF-Ⅱ)水平。采用放射免疫法检测骨钙素(BGP)、骨特异性碱性磷酸酶(BAP)水平。采用化学发光仪检测N端骨钙素(N-MID)、骨源性碱性磷酸酶(ABAP)水平。检测股骨颈骨密度(BMD)。Pearson法分析甲亢患者血清瘦素、脂联素及其与各指标间的相关性;采用受试者工作特征曲线(ROC)分析血清瘦素与脂联素对甲亢所致骨质疏松的诊断价值。 结果: 甲亢组血清瘦素与脂联素水平均显著高于对照组(P<0.05);甲亢组甲状腺激素指标中T3、T4、FT3、FT4、PTH水平显著高于对照组(P<0.05),TSH水平显著降低(P<0.05);甲亢组骨代谢相关细胞因子TNF、CT、IGF-Ⅱ水平均显著低于对照组(P<0.05),IL-6水平显著高于对照组(P<0.05);甲亢组骨代谢相关指标ALP、BGP、BAP、N-MID、ABAP水平均显著高于对照组(P<0.05),股骨颈BMD水平显著降低(P<0.05);Pearson法分析显示血清瘦素与脂联素呈正相关(P<0.05),且均与T3、T4、FT3、FT4、PTH呈正相关(P<0.05),与TSH呈负相关(P<0.05);Pearson法分析显示瘦素、脂联素与ALP、BGP、BAP、N-MID、ABAP、IL-6呈正相关(P<0.05),而与股骨颈BMD、TNF�Objective: To compare and analyze the changes of serum leptin and adiponectin levels in patients with hyperthyroidism and their relationships with thyroid hormone levels and bone metabolism. Methods: 78 patients with hyperthyroidism from April 2018 to March 2019 were selected as hyperthyroidism group, and 56 healthy volunteers were selected as control group. At the same time, patients with hyperthyroidism were divided into osteoporosis group (21 cases) and non-osteoporosis group (57 cases) according to whether they had osteoporosis. Serum leptin level was detected by radioimmunoassay and serum adiponectin level was detected by enzyme-linked immunosorbent assay (ELISA). The levels of serum thyroid hormone indexes such as triiodothyronine (T3), tetraiodothyronine (T4), free triiodothyronine (FT3), free thyroxine (FT4), parathyroid hormone (PTH), thyrotropin (TSH) were detected by chemiluminescence. The levels of bone metabolism-related cytokines such as interleukin-6 (IL-6), tumor necrosis factor (TNF), calcitonin (CT) and insulin-like growth factor-II (IGF-II) were measured by ELISA. The levels of osteocalcin (BGP) and bone specific alkaline phosphatase (BAP) were measured by radioimmunoassay. The levels of N-terminal osteocalcin (N-MID) and bone-derived alkaline phosphatase (ABAP) were measured by chemiluminescence. Bone mineral density (BMD) of femoral neck was measured. Pearson method was used to analyze serum leptin and adiponectin in patients with hyperthyroidism and their correlations with each index;the diagnostic value of serum leptin and adiponectin in hyperthyroidism-induced osteoporosis was analyzed by receiver operating characteristic curve (ROC). Results: The levels of serum leptin and adiponectin in hyperthyroidism group were significantly higher than those in control group (P < 0.05);the levels of T3, T4, FT3, FT4 and PTH in thyroid hormone indexes of hyperthyroidism group were significantly higher than those of control group (P < 0.05), and TSH level was significantly lower (P < 0.05);the levels of

关 键 词：甲状腺功能亢进症 瘦素 脂联素 甲状腺激素 骨代谢 

分 类 号：R581.1[医药卫生—内分泌]