Hypothyroidism and dyslipidemia: modern concepts and approaches.
Hypothyroidism and dyslipidemia: modern concepts and approaches.
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DOI：
10.1007/s11886-004-0054-3
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发表时间：
2004-11-01
影响因子：
3.7
通讯作者：
Pearce, Elizabeth N
中科院分区：
文献类型：
--
作者：
Pearce, Elizabeth N
亚临床和显性甲状腺功能减退是一般人群中相对常见的疾病。已知甲状腺激素在调节脂质的合成、代谢和动员中起作用。在明显的甲状腺功能减退症患者中，血清总胆固醇、低密度脂蛋白（LDL）胆固醇、载脂蛋白B、脂蛋白（a）水平以及可能的甘油三酯水平升高。亚临床甲状腺功能减退症对血脂值的影响尚不清楚。大量证据表明，亚临床甲状腺功能减退症患者的总胆固醇、LDL胆固醇和可能的甘油三酯升高，而高密度脂蛋白（HDL）胆固醇和Lp（a）保持不变。大多数明显甲状腺功能减退症患者的脂质异常将通过甲状腺激素替代治疗解决。然而，迄今为止的临床试验还没有显示甲状腺激素治疗对亚临床甲状腺功能减退症患者的血脂水平有有益的影响。甲状腺激素改变脂质的作用使其成为药物开发的一个有吸引力的目标。目前正在开发特异性靶向甲状腺激素类似物，可能治疗高脂血症而不会引起全身性甲状腺毒症。
Subclinical and overt hypothyroidism are relatively common disorders in the general population. Thyroid hormone is known to play a role in regulating the synthesis, metabolism, and mobilization of lipids. In patients with overt hypothyroidism there is an increase in serum total cholesterol, low-density lipoprotein (LDL) cholesterol, apolipoprotein B, lipoprotein(a) levels, and possibly triglyceride levels. The effects of subclinical hypothyroidism on serum lipid values are less clear. The preponderance of evidence suggests that total cholesterol, LDL cholesterol, and possibly triglycerides are increased in patients with subclinical hypothyroidism, whereas high-density lipoprotein (HDL) cholesterol and Lp(a) remain unchanged. Most lipid abnormalities in patients with overt hypothyroidism will resolve with thyroid hormone replacement therapy. However, clinical trials to date have not shown a beneficial effect of thyroid hormone treatment on serum lipid levels in patients with subclinical hypothyroidism. The lipid-altering effects of thyroid hormone make it an appealing target for drug development. The development of specifically targeted thyroid hormone analogues that could potentially treat hyperlipidemia without causing systemic thyrotoxicosis is currently ongoing.