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目的:研究原发性甲状腺功能减退症患者和甲状腺功能亢进患者血清同型半脱氨酸(Hcy)、血脂水平与心血管疾病的关系。方法:检测29例原发性甲减者、35例甲亢患者以及30例健康体检者(对照组)的空腹血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、Hcy、甘油三酯(TG)、总胆固醇(Tch)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平,并对其进行相关分析。结果:原发性甲减患者Hcy、TG、Tch、LDL-C水平明显高于对照组(p<0.01、0.01、0.01、0.01),而HDL-C水平却与对照组相比明显降低(p<0.01);相关分析表明,甲减患者Hcy与FT3、FT4水平间呈显著负相关(r=-0.432、-0.354,p<0.01、0.01),与TG、Tch水平呈显著正相关(r=0.339、0.452,p<0.01、0.01);而与HDL-C、LDL-C均无相关性。甲亢组Hcy和Tch水平较正常对照组明显降低(p<0.01、0.01),Hcy与FT4水平间呈显著负相关(r=-0.408,p<0.01)。结论:血清同型半胱氨酸水平可能对判断甲状腺功能有辅助作用;甲状腺激素水平影响了Hcy及血脂水平的代谢;血清Hcy水平升高是甲减患者易患心血管疾病的危险因素。
Objective: To study the relationship between serum homocysteic acid (Hcy), blood lipid levels and cardiovascular diseases in patients with primary hypothyroidism and hyperthyroidism. Methods: The levels of fasting serum free triiodothyronine (FT3), free thyroxine (FT4), Hcy, glycerol in 29 patients with primary hypothyroidism, 35 hyperthyroid patients and 30 healthy controls (control group) Triglyceride (TG), total cholesterol (Tch), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were measured and analyzed. Results: The levels of Hcy, TG, Tch and LDL-C in patients with primary hypothyroidism were significantly higher than those in the control group (p <0.01,0.01,0.01,0.01), but the levels of HDL-C were significantly lower than those in the control group <0.01). Correlation analysis showed that there was a significant negative correlation between Hcy and FT3 and FT4 levels in patients with hypothyroidism (r = -0.432, -0.354, p <0.01, 0.01), and positively correlated with TG and Tch levels (r = 0.339,0.452, p <0.01,0.01), but not with HDL-C and LDL-C. The levels of Hcy and Tch in hyperthyroidism group were significantly lower than those in normal control group (p <0.01, 0.01), and there was a significant negative correlation between Hcy and FT4 level (r = -0.408, p <0.01). CONCLUSIONS: Serum homocysteine levels may be helpful in judging thyroid function. Thyroid hormone levels affect the metabolism of Hcy and serum lipids. Increased serum levels of Hcy are risk factors for hypothyroidism in patients with hypothyroidism.