Association Between Thyroid Hormones, Thyroid Antibodies, and Cardiometabolic Factors in Non-Obese Individuals With Normal Thyroid Function.
Association Between Thyroid Hormones, Thyroid Antibodies, and Cardiometabolic Factors in Non-Obese Individuals With Normal Thyroid Function.
复制标题
甲状腺功能正常的非肥胖个体中甲状腺激素、甲状腺抗体和心脏代谢因素之间的关联
DOI：
10.3389/fendo.2018.00130
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发表时间：
2018
影响因子：
5.2
通讯作者：
Wang G
中科院分区：
文献类型：
--
作者：
Liu J;Duan Y;Fu J;Wang G
背景甲状腺功能减退是心血管疾病的重要危险因素，自身免疫性甲状腺炎(AIT)是导致甲状腺功能减退的主要原因。最近的研究表明，即使是甲状腺功能正常的AIT患者，早期动脉粥样硬化病变的数量也增加了。然而，确切的机制尚不清楚。本研究旨在探讨非肥胖性AIT患者的甲状腺功能、甲状腺自身免疫功能和心脏代谢危险因素与甲状腺功能正常的关系。方法纳入5,608名非肥胖者，包括1,402名AIT患者和4,206名性别、年龄和体重指数(BMI)匹配的健康对照。结果AIT患者血清游离T3、游离T4水平显著低于正常对照组，而TSH、抗甲状腺过氧化物酶抗体(TPOAb)、TgAb水平显著高于正常对照组。AIT组超敏C反应蛋白(HsCRP)水平和胰岛素抵抗稳态模型评分(HOMA-IR)较对照组升高[hsCRP：0.65(0.27~1.33)比0.20(0.03~0.74)mg/L；HOMA-IR：2.78 ± 1.60比2.33 ± 1.49；All P <； 0.05]。甲状腺功能与代谢参数和炎症指标无关，调整混杂因素后，TPOAb滴度与HOMA-IR和hsCRP水平呈正相关(均P <； 0.05)。多因素回归分析显示，TPOAb水平是影响HOMA-IR和hsCRP水平的独立因素(HOMA-IR：β = 0.058，P <； 0.05；hsCRP：β = 0.108，P <； 0.05)。结论在非肥胖者中，TPOAb水平与HOMA-IR和hsCRP水平相关，且与甲状腺功能无关。在非肥胖人群中，甲状腺功能在正常范围内的轻微偏离、慢性炎症和胰岛素抵抗可能是AIT与动脉粥样硬化之间的联系。
Background Hypothyroidism is an important risk factor for cardiovascular diseases, and autoimmune thyroiditis (AIT) is the leading cause of hypothyroidism. Recent studies showed that even AIT patients with euthyroidism still had an increased number of early atherosclerotic lesions. However, the precise mechanism is not yet known. This study aimed to investigate the association of thyroid function, thyroid autoimmunity, and cardiometabolic risk factors in non-obese AIT patients with euthyroidism. Methods A total of 5,608 non-obese individuals including 1,402 AIT patient and 4,206 sex-, age-, and body mass index (BMI)-matched healthy controls were recruited. Results The AIT patients had significantly lower free T3 and free T4 levels, and higher TSH, antithyroid peroxidase antibodies (TPOAb) and TgAb levels. The elevated levels of high sensitivity C reactive protein (hsCRP) and homeostasis model assessment of insulin resistance (HOMA-IR) were observed in the AIT patients than the controls [hsCRP: 0.65 (0.27–1.33) vs. 0.20 (0.03–0.74) mg/L; HOMA-IR: 2.78 ± 1.60 vs. 2.33 ± 1.49; all P < 0.05]. Thyroid function was not associated with metabolic parameters and inflammatory makers, while the TPOAb titer was positively associated with the HOMA-IR and hsCRP levels after adjustment for confounding factors (all P < 0.05). Multivariate regression analysis demonstrated that the TPOAb level was an independent influencing factor for the HOMA-IR and hsCRP levels (HOMA-IR: β = 0.058, P < 0.05; hsCRP: β = 0.108, P < 0.05). Conclusion The TPOAb level is associated with HOMA-IR and hsCRP levels independently of thyroid function in non-obese individuals. Mild deviation of thyroid function within the normal range, chronic inflammation, and insulin resistance may be the links between AIT and atherosclerosis in the non-obese population.