甲状腺功能正常人群甲状腺激素抵抗与高尿酸血症的相关性  

Relationship between thyroid hormone resistance and hyperuricemia in population with normal thyroid function

作　　者：孙蔚雯 王晶 康丽惠 康林 刘婷 梁丽丽 牛永红 Sun Yuwen;Wang Jing;Kang Lihui;Kang Lin;Liu Ting;Liang Lili;Niu Yonghong(Department of Cardiology,First Affiliated Hospital of Tsinghua University,Beijing 100016,China;Health Management Centre,First Affiliated Hospital of Tsinghua University,Beijing 100016,China)

机构地区：[1]清华大学第一附属医院心脏中心,北京100016 [2]清华大学第一附属医院健康管理中心,北京100016

出　　处：《中华健康管理学杂志》2024年第6期428-432,共5页Chinese Journal of Health Management

基　　金：清华大学春风基金(2020Z99CFY037)。

摘　　要：目的分析甲状腺功能正常人群的甲状腺激素抵抗与高尿酸血症的相关性。方法本研究为横断面研究,选取2021年1月至2022年12月在清华大学第一附属医院心脏中心及健康管理中心住院和体检的甲状腺功能正常者548例。检测所有受试者的血液甲状腺激素、尿酸、血脂等指标,计算甲状腺功能参数:促甲状腺激素指数(TSHI)、促甲状腺激素甲状腺素抵抗指数(TT4RI)、参数化甲状腺反馈分位数指数(PTFQI)、游离三碘甲腺原氨酸/游离甲状腺素(FT3/FT4)、外周脱碘酶活性总和(SPINA-GD)和甲状腺最大分泌能力(SPINA-GT)。根据血尿酸水平分为高尿酸血症组和正常组,比较两组的临床特征和甲状腺功能参数;探究甲状腺激素抵抗与高尿酸血症的关系。结果与正常组相比,高尿酸血症组中男性(94.4%和52.5%)、吸烟者占比(35.2%和21.3%)、体重指数[(27.10±3.96)和(24.26±3.42)kg/m2]、腰臀比[0.90(0.86,0.94)和0.86(0.80,0.91)]、肌酐[(85.50±12.27)和(73.77±28.79)μmol/L]、总胆固醇[(5.08±0.99)和(4.72±0.86)mmol/L]、甘油三酯[2.10(4.40,5.59)和1.14(0.79,1.67)mmol/L]、低密度脂蛋白[(3.19±0.97)和(2.85±0.84)mmol/L]、同型半胱氨酸[(15.07±9.13)和(12.50±10.85)μmol/L]水平较高,高密度脂蛋白[1.15(1.43,2.88)和1.39(1.16,1.64)mmol/L]水平较低(P<0.05);甲状腺激素及甲状腺功能参数方面,高尿酸血组比正常组在FT4[16.90(15.40,17.95)和16.00(14.30,17.80)pmol/L]、FT3[5.56(5.25,5.94)和5.22(4.81,5.63)pmol/L]、FT3/FT4[0.34(0.31,0.37)和0.32(0.29,0.36)]、TSHI(2.70±0.50和2.58±0.60)、PTFQI(0.406±0.332和0.335±0.353)及SPINA-GD[3.72(3.41,4.05)和3.52(3.18,4.00)]方面水平较高(均P<0.05)。Spearman相关分析显示,血尿酸水平与FT4(r=0.185)、FT3(r=0.422)、FT3/FT4(r=0.16)、TSHI(r=0.134)、TT4RI(r=0.09)、PTFQI(r=0.121)、SPINA-GD(r=0.157)呈正相关(均P<0.05)。结论甲状腺功能正常的人群中,甲状腺激素中枢性抵抗与高尿酸血症相关。Objective To investigate the correlation between thyroid hormone resistance and hyperuricemia in euthyroid population.Methods It was a cross-sectional study.A total of 548 euthyroid subjects who were hospitalized or underwent physical examination in the Heart Center and Health Management Center of the First Affiliated Hospital of Tsinghua University from January 2021 to December 2022 were selected.Thyroid function,uric acid,blood lipid and other indicators were collected in the subjects,and thyroid function parameters were calculated:thyroid-stimulating hormone index(TSHI),thyrotropin T4 resistance index(TT4RI),parametric thyroid feedback quantile-based index(PTFQI),free triiodothyronine/free thyroxine(FT3/FT4),the sum activity of peripheral deiodinases(SPINA-GD)and the secretory capacity of the thyroid gland(SPINA-GT).According to uric acid level,the subjects were divided into high uric acid group and normal group,the clinical characteristics and thyroid function parameters of the two groups were compared,the correlation between thyroid hormone resistance and hyperuricemia was further explored.Results Compared with the normal group,male proportion(94.4%and 52.5%),smoking rate(5.2%and 21.3%),body mass index[(27.10±3.96)and(24.26±3.42)kg/m2],waist-to-hip ratio[0.90(0.86,0.94)and 0.86(0.80,0.91)],serum creatinine[(85.50±12.27)and(73.77±28.79)μmol/L],total cholesterol[(5.08±0.99)and(4.72±0.86)mmol/L],triglyceride[2.10(4.40,5.59)and 1.14(0.79,1.67)mmol/L],low-density lipoprotein[(3.19±0.97)and(2.85±0.84)mmol/L]and homocystine[(15.07±9.13)and(12.50±10.85)μmol/L]were all higher in the high uric acid group,and the level of high-density lipoprotein[1.15(1.43,2.88)and 1.39(1.16,1.64)mmol/L]was lower(all P<0.05).In the aspect of thyroid hormone and thyroid function parameters,the FT4[16.90(5.40,17.95)and 16.00(14.30,17.80)pmol/L],FT3[5.56(5.25,5.94)and 5.22(4.81,5.63)pmol/L],FT3/FT4[0.34(0.31,0.37)and 0.32(0.29,0.36)],TSHI(2.70±0.50 and 2.58±0.60),PTFQI(0.406±0.332 and 0.335±0.353)and SPINA-GD[3.72(3.41,4.0

关 键 词：甲状腺激素 甲状腺激素敏感性 尿酸 高尿酸血症 

分 类 号：R589.7[医药卫生—内分泌]