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目的探讨亚临床甲状腺功能减退症(subclinical hypothyroidism,SH)患者血管内皮功能变化及其与促甲状腺激素(thyroid stimulating hormone,TSH)的相关性。方法 SH患者64例(SH组),同期体检健康者30例(对照组),检测2组血清游离三碘甲状腺原氨酸、游离甲状腺素、促甲状腺素、高敏C反应蛋白、内皮素-1、一氧化氮、总胆固醇、低密度脂蛋白胆固醇、三酰甘油、高密度脂蛋白胆固醇、载脂蛋白A1、载脂蛋白B水平,并行超声检查观察2组肱动脉血流介导的内皮依赖性血管舒张功能(flow mediated vasodilation,FMD);Spearman相关分析SH组患者TSH与上述指标的相关性。结果 SH组TSH、总胆固醇、低密度脂蛋白胆固醇、载脂蛋白B、超敏C反应蛋白及血管内皮素-1水平高于对照组,FMD、一氧化氮水平低于对照组(P<0.05);SH组TSH与总胆固醇(r=0.463,P<0.036)、载脂蛋白B(r=0.364,P=0.001)、高敏C反应蛋白水平呈正相关(r=0.486,P=0.015),与FMD呈负相关(r=-0.425,P=0.005)。结论SH患者存在脂质代谢紊乱与血管内皮功能障碍。
Objective To investigate the changes of vascular endothelial function and its correlation with thyroid stimulating hormone (TSH) in patients with subclinical hypothyroidism (SH). Methods Sixty - four SH patients (SH group) and 30 healthy subjects (control group) were enrolled in the study. Serum free triiodothyronine, free thyroxine, thyrotropin, high - sensitivity C - reactive protein, , Nitric oxide, total cholesterol, low density lipoprotein cholesterol, triglyceride, high density lipoprotein cholesterol, apolipoprotein A1, apolipoprotein B levels were measured. The brachial artery-endothelium dependent Flow mediated vasodilation (FMD); Spearman correlation analysis of SH group patients with TSH and the above indicators. Results The levels of TSH, total cholesterol, low density lipoprotein cholesterol, apolipoprotein B, high sensitivity C-reactive protein and endothelin-1 in SH group were higher than those in control group, while the levels of FMD and NO were lower in SH group than those in control group (R = 0.486, P = 0.015). The levels of total cholesterol (r = 0.463, P <0.036) and apolipoprotein B (r = 0.364, P = 0.001) and high sensitivity C-reactive protein FMD was negatively correlated (r = -0.425, P = 0.005). Conclusion SH patients have dyslipidemia and vascular endothelial dysfunction.