【摘要】 目的了解不同程度亚临床甲状腺功能减退症(SCH)对患者血脂、血糖代谢水平、胰岛素敏感性、心血管疾病危险因子的影响,从而了解它们之间的相互关系。方法通过性别、年龄匹配,选择笔者医院2005年6月~2010年6月5年间住院患者共210名,根据TSH水平,将其分为轻症组(82位),重症组(44位),对照组(84位)。分别对3组患者的体重指数(BMI)、甲状腺功能指标(TSH,FT3,FT4)、脂代谢(TC、TG、HDL-C、LDL-C、ApoA、ApoB)、糖代谢及胰岛素抵抗参数(FBS,FINS,HOMA-IR)、心血管疾病危险因子(hsCRP)进行比较,并进行统计学分析;比较SCH组及对照组TC升高、TG升高及患非酒精性脂肪肝患者的比率;对SCH患者的各观察指标变量与TSH进行相关性分析。结果重症SCH组BMI及FT4与轻症SCH组及对照组有显著性差异,TC、LDL-C、ApoB、FINS、CRP在重症及轻症SCH组中显著增高,与对照组比较有统计学差异,TG在重症SCH组比对照组显著性升高;在SCH组ApoB、BMI、LDL-C、FINS、TG与TSH显著正相关,FT4、FT3与TSH显著负相关;TC升高的患者比率及患非酒精性脂肪肝患者比率,SCH组显著高于对照组。结论亚临床甲状腺功能减退症已经造成了正常范围内的FT4的显著升高,患者血脂水平,空腹胰岛素水平明显升高,并增加了动脉粥样硬化的危险性和肥胖的可能性,也可能是非酒精性脂肪肝的发病因素之一。SCH虽然症状轻微,但应引起临床医生的充分重视。更多还原

【Abstract】 Objective To explore the effect of different degree subclinical hypothroidism(SCH) on lipid metabolism,glycometabolism,insulin sensitivity and cardiovascular diseases risk factor.Methods The clinical data of 126 adult patients with subclinical hypothroidism from June 2005 to June 2010 were selected by matching age and sex.It was a retrospective study,and statistical analysis was performed to compare the differences in severe SCH(44 patients),mild SCH(82 patients) and control group(84 patients) from BMI,TSH,FT3,FT4,TC,TG,HDL-C,LDL-C,ApoA,ApoB,FBS,FINS,HOMA-IR and hsCRP.Correlation analysis was estimated between TSH and above parameter in patients with SCH.Results BMI and FT4 were significantly different in patients with severe SCH as compared with mild SCH and control group.TC,LDL-C,ApoB,FINS,CRP was significantly higher in the mild and severe SCH group as compared to the control group.There was significant difference in TG between servere SCH and control group.TSH was found to have positive correlation with ApoB,BMI,LDL-C,FINS,TG in SCH.Patients with SCH exhibited elevated incidence rate of nonacohol fatty liver and hypercholesterolemia.Conclusion Subclinical hypothroidism would lead to heighten FT4 in normal limits.Patients exhibited elevated serum Lipid and FINS.SCH easily progress nonacohol fatty liver and atherosclerosis.It is important to pay close attention to SCH for clinician.更多还原