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Effect of treatment of overt hypothyroidism on insulin resistance 被引量:2
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作者 Aml Mohamed Nada 《World Journal of Diabetes》 SCIE CAS 2013年第4期157-161,共5页
AIM: To investigate the impact of hypothyroidism and thyroxine therapy on insulin sensitivity in patients with overt hypothyroidism.METHODS: The study included twenty seven overtly hypothyroid and fifteen healthy euth... AIM: To investigate the impact of hypothyroidism and thyroxine therapy on insulin sensitivity in patients with overt hypothyroidism.METHODS: The study included twenty seven overtly hypothyroid and fifteen healthy euthyroid South Western Asian females.Both groups had matching age and body mass index.Physiological and pathological conditions as well as medications that may alter thyroid function,glucose homeostasis or serum lipids were ruled out.Serum thyrotropin(TSH),free tetraiodothyronine(FT4),free triiodothyronine(FT3),fasting insulin(FI),fasting plasma glucose(FPG),total cholesterol and triglycerides were measured before and six months after initiating thyroxine therapy for hypothyroid patients and once for the control group.Insulin resistance(IR) was estimated using homeostasis model assessment(HOMA-IR) and Body mass index(BMI) was calculated.RESULTS: Both study groups,hypothyroid patients and euthyroid control subjects,had matching age and body mass index(P-value 0.444,0.607 respectively).No significant difference was found between the hypothyroid patients and the euthyroid control group regarding fasting plasma glucose,fasting insulin,insulin resistance,total cholesterol and triglycerides(P-values 0.432,0.621,0.883,0.586,0.05 respectively).In the hypothyroid patients,triglycerides showed direct correlation to TSH and inverse correlation to FT3.Similarly total cholesterol inversely correlated to FT3 but its direct correlation to TSH did not reach statistical significance.After thyroxine replacement and reaching an euthyroid state as confirmed by clinical and laboratory data,there was no significant change in fasting plasma glucose,insulin resistance or triglyceride level(P-value 0.216,0.204,0.175 respectively) while total cholesterol significantly decreased(P-value 0.043) and fasting insulin significantly increased(P-value 0.047).CONCLUSION: Hypothyroidism has no impact on insulin sensitivity.Correction of hypothyroidism is not associated with a significant change of insulin sensitivity or triglycerides,but with a significant reduction of total cholesterol. 展开更多
关键词 hypothyroidism Female THYROXINE INSULIN resistance TRIGLYCERIDES CHOLESTEROL
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Overt Hypothyroidism in Hospitalized Patients: Clinical Characteristics
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作者 Pnina Rotman-Pikielny Oksana Borodin +1 位作者 Rivka Zissin Yair Levy 《Open Journal of Endocrine and Metabolic Diseases》 2013年第2期128-131,共4页
Objectives: Hypothyroidism is usually detected in an outpatient setting, but might be diagnosed during hospitalization. The prevalent symptoms are not fully defined. This study aimed to determine the clinical characte... Objectives: Hypothyroidism is usually detected in an outpatient setting, but might be diagnosed during hospitalization. The prevalent symptoms are not fully defined. This study aimed to determine the clinical characteristics of in-patients with overt hypothyroidism. Methods: The medical records of 23 inpatients (16F/7M, age 61.5 ± 21.8 years), who had 29 admissions with a primary diagnosis of hypothyroidism from January 1997 to December 2007 were retrospectively reviewed. They comprised 0.01% of all adult medical admissions during the study. Results: Fifty-five percent had a pre-admission diagnosis of hypothyroidism, 10% were nursing home residents and 38% had cognitive decline. Sixtynine percent presented with multiple complaints, mostly weakness and constipation, reported by 89% and 68%, respectively. Thyrotropin level was 74.3 ± 53.5 mIU/L (normal 0.23 - 4) and free thyroxine was 0.43 ± 0.29 ng/dL (normal 0.8 - 2). Elevated creatinine phosphokinase, anemia (hemoglobin 12 g/dL) and hyponatremia (sodium 135 mEq/L) were present in 89%, 62%, and 13%, respectively. Conclusions: Overt hypothyroidism during hospitalization occurs infrequently and mostly in patients with previously diagnosed hypothyroidism. Clinical manifestations include multiple non-specific symptoms, mainly weakness and constipation, while typical “hypothyroid” symptoms such as cold intolerance and weight gain are often overlooked. A high index of suspicion is needed to detect hypothyroidism in the hospital setting. 展开更多
关键词 hypothyroidism HOSPITALIZED PATIENTS INPATIENTS
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Cardiac Malformations in Congenital Hypothyroidism: A Case Report
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作者 Suzanne Sap Gaelle Ntsoli +3 位作者 Jocelyn Tony Ritha Mbono Helene Kamo David Chelo 《Open Journal of Pediatrics》 2024年第2期279-284,共6页
Introduction: Congenital hypothyroidism is the most common causes of preventable mental retardation. It is associated with other births defects like cardiac malformations. Descriptions in Sub Saharan Africa are rare, ... Introduction: Congenital hypothyroidism is the most common causes of preventable mental retardation. It is associated with other births defects like cardiac malformations. Descriptions in Sub Saharan Africa are rare, justifying the present report. Case Report: We reported the cases of 3 female patients, diagnosed with hypothyroidism, presenting in addition pulmonary stenosis. The diagnosis was late in all the patients and we noticed clinical improvement under levothyroxine. Conclusion: Association congenital hypothyroidism and cardiac defect is not rare. Our patients are female with no history of consanguinity, presenting congenital hypothyroidism with a gland in situ associated with pulmonary stenosis. Systematic screening of other births defects is thus recommended in affected patients. 展开更多
关键词 Congenital hypothyroidism Cardiac Malformations CHILDREN
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Overt hypothyroidism with rhabdomyolysis and myopathy: a case report 被引量:3
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作者 KUO Hsu-tung JENG Chii-yuan 《Chinese Medical Journal》 SCIE CAS CSCD 2010年第5期633-637,共5页
关键词 甲状腺功能减退 病例报告 肌病 横纹肌 溶解 显性 肌酸激酶 非特异性
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Combined prednisone and levothyroxine improve treatment of severe thrombocytopenia in hepatitis B with compensatory cirrhosis accompanied by subclinical and overt hypothyroidism 被引量:8
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作者 Jing Xue Ru Feng +13 位作者 Haixia Fu Qian Jiang Hao Jiang Jing Lu Hui Liu Jingwen Wang Ting Niu Xin Wang YANDi Xie Hao Wang Lanping Xu Kaiyan Liu Xiaojun Huang Xiaohui Zhang 《Science China(Life Sciences)》 SCIE CAS CSCD 2018年第8期924-933,共10页
The aim of the present study was to investigate the relationship between hypothyroidism and thrombocytopenia in hepatitis Brelated compensatory liver cirrhosis and to determine whether treatment with levothyroxine and... The aim of the present study was to investigate the relationship between hypothyroidism and thrombocytopenia in hepatitis Brelated compensatory liver cirrhosis and to determine whether treatment with levothyroxine and prednisone is superior in a multicenter, open-label, observational study in China. In total, 125 consecutive hepatitis B-related compensated liver cirrhosis patients with severe thrombocytopenia accompanied by hypothyroidism were included. The patients were divided into four groups according to treatment strategy: a control group(n=29), a prednisone group(n=25), a levothyroxine group(n=32) and a prednisone plus levothyroxine group(n=39). Severe thrombocytopenia was more prevalent in hepatitis B-associated compensatory liver cirrhosis patients with hypothyroidism than in euthyroid patients(29.6% vs. 14.7%, P<0.05). Combination treatment with prednisone and levothyroxine decreased the risk of bleeding and improved platelet recovery compared to control treatment and treatment with either prednisone or levothyroxine alone. The platelet count before therapy, serum thyroid stimulating hormone and combination treatment with prednisone and levothyroxine were associated with bleeding events. Therefore, the present study suggests that hypothyroidism is associated with severe thrombocytopenia in hepatitis B-associated compensatory liver cirrhosis. Treatment with prednisone plus levothyroxine may present a novel approach in these patients. 展开更多
关键词 联合治疗 泼尼松 甲状腺 肝硬化 肝炎 补偿 机能 临床症状
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Mechanism of intervention of medicine combined with mild moxibustion on hypothyroidism rat model
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作者 WANG Hong-yang SUN Jia-zi +3 位作者 LIU Qing-qing YAN Jing ZHANG Tian-sheng HAO Chong-yao 《Journal of Hainan Medical University》 2023年第4期46-51,共6页
Objective:To explore the intervention effect of medicine combined with mild moxibustion on immune factor and Na/I symporter(NIS)in hypothyroidism rat model.Methods:The model was successfully made by intragastric admin... Objective:To explore the intervention effect of medicine combined with mild moxibustion on immune factor and Na/I symporter(NIS)in hypothyroidism rat model.Methods:The model was successfully made by intragastric administration of propylthiouracil(PTU)solution medicine and medicine combined with mild moxibustion groups were given levothyroxine sodium suspension 60μg/kg body weight by gavage,once a day.In the medicine combined with mild moxibustion group,mild moxibustion was applied in“Dazhui”,“Mingmen”,“Pishu”,“Shenshu”,and 10 minutes per point,once a day,and one day off every six days;four weeks in a row.The model group and medicine was fixed in the same way as the medicine combined with mild moxibustion group.The blank group received no treatment.The contents of thyrotropin-releasing hormone(TSH),tatalthyroxine(TT4),thyroid peroxidase antibody(TPOAb),thyroglobulin antibodies(TGAb),Interleukin-4(IL-4)and Interleukin-23(IL-23)in serum were determined by Enzyme Linked Immunosorbent Assay(ELISA).The content of NIS and the expression level of NISmRNA in thyroid tissues of each group were detected by immunohistochemistry and real-time polymerase chain reaction(R-T PCR).Results:Compared with the blank group,the contents of TSH,TPOAb,TGAb and IL-23 in the serum of rats in the model group were increased,the contents of IL-4 and TT4 were decreased,and the contents of NIS and NISmRNA in thyroid tissue were decreased,with statistical significance(P<0.01).Compared with model group,the contents of TSH,TPOAb,TGAb and IL-23 in serum of medicine group and medicine combined with mild moxibustion group were decreased,while the contents of IL-4 and TT4 were increased;the NIS content and NISmRNA expression in thyroid tissues were increased,and the differences were statistically significant(P<0.01).Compared with the medicine group,NISmRNA expression in thyroid tissues of medicine combined with mild moxibustion groups was increased,and the difference was statistically significant(P<0.05).Conclusion:Medicine combined with mild moxibustion can decrease the contents of TPOAb,TGAb and IL-23,and increase the content of IL-4,increasing the content and expression of NIS to interfere with the hypothyroidism rat model. 展开更多
关键词 hypothyroidism INTERLEUKIN-4 INTERLEUKIN-23 Na/I symporter Medicine combined with mild moxibustion
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Traditional Chinese medicine prescriptions and herbs for the treatment of hypothyroidism:a narrative review
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作者 Jun-Qi Li Ying Li +5 位作者 Jia-Chang Niu Yi-Han Huang Jia-Cheng Zhang Jing Zhang Meng-Yao Tang Wei Dang 《TMR Integrative Medicine》 2023年第24期1-24,共24页
The increasing prevalence of hypothyroidism,which can cause endocrine dysfunction,abnormal neurological function,and cardiovascular and cerebrovascular injuries,poses serious health problems.Thyroid hormone supplement... The increasing prevalence of hypothyroidism,which can cause endocrine dysfunction,abnormal neurological function,and cardiovascular and cerebrovascular injuries,poses serious health problems.Thyroid hormone supplementation constitutes the current main therapeutic method for hypothyroidism,yet it has many limitations and risks and is not suitable for everyone.Therefore,it is necessary to seek alternative and complementary treatment methods.It has been proven in practice that traditional Chinese medicine(TCM)possesses multi-channel comprehensive characteristics for the treatment of hypothyroidism and has more advantages than single thyroid hormone supplementation.Through a comprehensive examination of existing literature about TCM efficacy in addressing hypothyroidism,we have meticulously consolidated the most recent research findings on prescriptions and herbal substances employed in the treatment of this condition.Furthermore,we have explicated their respective functions in the management of hypothyroidism,thereby offering valuable perspectives and recommendations for the prospective utilization of natural remedies in its treatment. 展开更多
关键词 traditional Chinese medicine hypothyroidism PRESCRIPTIONS single herb action mechanism
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An Empirical Study on the Differences between Overt Translation and Covert Translation in Legal
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作者 Chunxu Qian 《Journal of Educational Theory and Management》 2023年第1期12-16,共5页
Currently,it is key to convey precise meanings to readers for translators.Observing expressing habits between different languages is the precondition to make target texts more readable.It is crucial to ensure the exac... Currently,it is key to convey precise meanings to readers for translators.Observing expressing habits between different languages is the precondition to make target texts more readable.It is crucial to ensure the exactness and seriousness of legal texts,but it does not mean that translators have to take machined way to leave out and even give up transmitting in-deep cultural implications for the intention of achieving the all-inclusive integrity of target content.It is a correct choice for translators to take overt translation and covert translation in line with traits of source language and target language and differences between civil law system and common law system.The intention of the article is to make an empirical study between overt translation and covert translation. 展开更多
关键词 Legal text overt translation Covert translation READABILITY Empirical study
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成人ICU患者显性误吸影响因素分析
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作者 王彩虹 刘霞琴 +3 位作者 覃双文 陆秀红 李玲 黄德斌 《护理学杂志》 CSCD 2024年第1期60-63,共4页
目的探讨成人ICU患者发生显性误吸的影响因素,为识别高危人群、降低显性误吸发生率提供参考。方法选取成人ICU患者798例,利用单因素分析和logistic回归分析探讨显性误吸的影响因素。结果成人ICU患者显性误吸发生率为16.9%,机械通气、胃... 目的探讨成人ICU患者发生显性误吸的影响因素,为识别高危人群、降低显性误吸发生率提供参考。方法选取成人ICU患者798例,利用单因素分析和logistic回归分析探讨显性误吸的影响因素。结果成人ICU患者显性误吸发生率为16.9%,机械通气、胃残余量、腹腔内压力、误吸史、呕吐是危险因素(均P<0.05)。结论成人ICU患者有发生显性误吸的风险,需重点关注机械通气、有误吸史及呕吐的患者,减少胃残余量和降低腹腔内压力,以减少显性误吸。 展开更多
关键词 成人 ICU 误吸 显性误吸 机械通气 胃残余量 腹腔内压力 呕吐
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甲状腺功能异常对凝血系统的影响及治疗药物相互作用研究进展
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作者 蒋敏 边原 龙恩武 《医药导报》 CAS 2024年第1期85-90,共6页
甲状腺功能异常患者的凝血指标可出现异常,存在潜在发生血栓或出血的风险。甲状腺功能亢进患者存在显著的血管内皮功能紊乱并引起血栓风险,但关于甲状腺功能减退对凝血功能的影响仍存在争议。甲状腺功能异常对凝血系统的潜在风险可能干... 甲状腺功能异常患者的凝血指标可出现异常,存在潜在发生血栓或出血的风险。甲状腺功能亢进患者存在显著的血管内皮功能紊乱并引起血栓风险,但关于甲状腺功能减退对凝血功能的影响仍存在争议。甲状腺功能异常对凝血系统的潜在风险可能干扰抗凝药物治疗安全性,同时甲状腺疾病治疗药物与抗凝药物之间的相互作用也对患者的用药安全造成影响。该文基于既往研究文献分析甲状腺功能异常与凝血功能相关性,评估和探讨甲状腺功能异常对凝血系统的影响及相关治疗药物相互作用,以期为甲状腺功能紊乱合并凝血功能异常患者的诊治提供参考。 展开更多
关键词 甲状腺功能亢进症 甲状腺功能减退症 抗甲状腺药 甲状腺素 抗凝药 促凝药 药物相互作用 凝血系统
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《山海经》名物书写的基本样式和运思机制
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作者 李炳海 《中原文化研究》 2024年第1期95-100,共6页
《山海经》之中的名物数量众多,种类繁富,是构成全书的基本骨架。其中名物的含义有显豁与隐晦之分,还有的则介于二者之间。造成含义隐晦的原因,是名物所用词语往往取其原始本义、特殊义,而不是常见用法;还有的文字属于多音、多义词。名... 《山海经》之中的名物数量众多,种类繁富,是构成全书的基本骨架。其中名物的含义有显豁与隐晦之分,还有的则介于二者之间。造成含义隐晦的原因,是名物所用词语往往取其原始本义、特殊义,而不是常见用法;还有的文字属于多音、多义词。名物指称对象有的是一种物,有的则是一个类别,后者运用的是综合思维。《山海经》以各个条目为相对独立的结构单元,各条目之间不存在意义的直接关联,呈现的是间断性。而在条目内部出现的名物,往往存在意义上的关联,是以条目标题名物所承载的理念统辖其他名物,连续出现的名物呈链状或网状。中国古代神话的片断性特征,很大程度上是由这种书写方式造成的。 展开更多
关键词 《山海经》 名物书写 隐与显 同与异 断与续
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妊娠早、中期妇女尿碘/尿肌酐比值与亚临床甲状腺功能减退症合并自身抗体阳性的相关性
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作者 梁愿 王青 +3 位作者 吴芳 余红岚 许小红 周佳敏 《黑龙江医学》 2024年第8期927-930,共4页
目的:探讨妊娠早、中期妇女尿碘/尿肌酐比值(UIC/UCr)与亚临床甲状腺功能减退症(SCH)合并自身抗体阳性的相关性。方法:回顾性选取2018年1月—2021年6月贵阳市第一人民医院进行孕检的妊娠早、中期SCH孕妇作为研究对象,依据甲状腺自身抗... 目的:探讨妊娠早、中期妇女尿碘/尿肌酐比值(UIC/UCr)与亚临床甲状腺功能减退症(SCH)合并自身抗体阳性的相关性。方法:回顾性选取2018年1月—2021年6月贵阳市第一人民医院进行孕检的妊娠早、中期SCH孕妇作为研究对象,依据甲状腺自身抗体检测结果,将其分为:妊娠早、中期甲状腺抗体阳性组;妊娠早、中期甲状腺抗体阴性组;另选取同时期进行检查的妊娠早、中期健康孕妇作为对照组,每组各100例,共计300例,观察甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)、UIC/UCr、促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、血清游离甲状腺素(FT4)等指标。结果:妊娠早期三组孕妇一般临床资料比较,差异无统计学意义(P>0.05),妊娠中期三组孕妇收缩压(SBP)、舒张压(DBP)比较,差异有统计学意义(F=7.024、11.357,P<0.05);UIC/UCr分析显示,与其他组别比较,妊娠早、中期阳性组孕妇均值和百分位分布数值最低;甲状腺激素及抗体水平比较,除FT3和FT4外,妊娠早、中期阳性组孕妇UIC/UCr、TPOAb、TgAb和TSH水平与健康组和阴性组比较,差异有统计学意义(F=71.710、279.102、130.017、275.949、22.991、220.702、288.882、184.459,P<0.001);相关性分析结果显示,UIC/UCr与TSH、TgAb、TPOAb水平呈负相关;多元线性回归分析结果发现,UIC/UCr、TSH是TPOAb、TgAb的主要影响因素。结论:妊娠早、中期SCH合并自身抗体阳性孕妇,UIC/UCr显著偏低且与TPOAb、TgAb关系密切,建议在临床中加强UIC/UCr指标观察。 展开更多
关键词 妊娠早、中期 尿碘尿肌酐比值 亚临床甲状腺功能减退症 甲状腺自身抗体阳性
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温阳健脾法联合维生素D调节免疫失衡治疗桥本甲减的研究
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作者 汪燕燕 张汝琪 +2 位作者 刘娜娜 部翰明 张欣梅 《宁夏医学杂志》 CAS 2024年第2期121-124,共4页
目的观察温阳健脾法联合维生素D调节免疫失衡,治疗桥本甲状腺炎(HT)合并甲减的疗效。同时通过检测HT甲减期患者治疗前后Th17和Treg细胞表达的百分率,以评估临床疗效。方法选取收治的住院及门诊病人64例作为研究对象,随机分为对照组和实... 目的观察温阳健脾法联合维生素D调节免疫失衡,治疗桥本甲状腺炎(HT)合并甲减的疗效。同时通过检测HT甲减期患者治疗前后Th17和Treg细胞表达的百分率,以评估临床疗效。方法选取收治的住院及门诊病人64例作为研究对象,随机分为对照组和实验组各32例,对照组给予维生素D,试验组给予复方甲减平合剂+维生素D,疗程为8周,比较2组患者的中医证候疗效,血清促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、甲状腺过氧化物酶抗体(TPO-AB)、甲状腺球蛋白抗体(TGAb)、Th17和Treg细胞表达的百分率及甲状腺体积变化。结果治疗前后中医证候积分改善情况试验组明显优于对照组(P<0.05);2组患者在治疗后FT3、FT4、TSH水平及甲状腺体积对比疗效相当(P>0.05)。2组患者治疗前后甲状腺抗体指标比较,试验组的疗效优于对照组(P<0.05)。结论温阳健脾法联合维生素D治疗桥本甲减安全性较高,不良反应少,值得在临床中广泛应用。 展开更多
关键词 桥本甲状腺炎合并甲状腺功能减退症 温阳健脾 维生素D 免疫失衡
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甲状腺功能检测联合TG-Ab、TPO-Ab水平检查对亚临床甲减患者的诊断效果
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作者 赵琪 《临床医学研究与实践》 2024年第8期97-100,共4页
目的分析甲状腺功能检测联合抗甲状腺球蛋白抗体(TG-Ab)、甲状腺过氧化物酶抗体(TPO-Ab)水平检查对亚临床甲减患者的诊断效果。方法选取2021年10月至2023年10月我院收治的100例疑似亚临床甲减患者为观察组,再选取同期到院进行常规体检的... 目的分析甲状腺功能检测联合抗甲状腺球蛋白抗体(TG-Ab)、甲状腺过氧化物酶抗体(TPO-Ab)水平检查对亚临床甲减患者的诊断效果。方法选取2021年10月至2023年10月我院收治的100例疑似亚临床甲减患者为观察组,再选取同期到院进行常规体检的100名健康志愿者为对照组。所有研究对象入院后均进行甲状腺功能与TG-Ab、TPO-Ab水平检测,对比分析两种检查单独与联合应用时的诊断效能。结果两组的游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)水平比较,差异无统计学意义(P>0.05);观察组的促甲状腺激素(TSH)、TG-Ab、TPO-Ab水平高于对照组,差异具有统计学意义(P<0.05)。TSH、FT3、FT4和TG-Ab、TPO-Ab联合检测对亚临床甲减的诊断准确度、灵敏度高于单独检测(P<0.05)。结论甲状腺功能联合TG-Ab、TPO-Ab检测诊断亚临床甲减可取得较高的诊断效能。 展开更多
关键词 亚临床甲减 甲状腺功能 抗甲状腺球蛋白抗体 甲状腺过氧化物酶抗体
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脂代谢异常人群亚临床甲状腺功能减退患病率及相关因素研究
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作者 陈秀勤 蒙秀坚 +1 位作者 莫石贤 邱永佳 《临床研究》 2024年第3期1-4,共4页
目的探讨脂代谢异常人群亚临床甲状腺功能减退(SCH)患病率及相关因素。方法选择梧州市红十字会医院2018年1月至2022年12月收入的3650例脂代谢异常人群,分析SCH患病率,对SHC患者和非SCH患者的临床资料进行对比,将有差异项目带入Logistic... 目的探讨脂代谢异常人群亚临床甲状腺功能减退(SCH)患病率及相关因素。方法选择梧州市红十字会医院2018年1月至2022年12月收入的3650例脂代谢异常人群,分析SCH患病率,对SHC患者和非SCH患者的临床资料进行对比,将有差异项目带入Logistic回归方程计算,分析其对脂代谢异常人群患SCH的影响。结果脂代谢异常人群中SCH患者962例,患病率26.36%;对SCH患者及非SCH患者一般资料进行单因素Logistic回归分析发现性别、身体质量指数(BMI)、甘油三酯(TG)、舒张压(DP)、抗甲状腺球蛋白抗体(TgAb)、收缩压(SP)、年龄、空腹血浆葡萄糖(FBG)、低密度脂蛋白(LDL-C)、负荷后2 h血糖(2hPG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、谷草转氨酶(AST)、血钙、血磷、血尿酸(UA)、抗甲状腺过氧化物酶抗体(TPOAb)在两组中差异有统计学意义(P<0.05);不同种类脂代谢异常以高TG血症居多,差异有统计学意义(P<0.05),而脂代谢异常人群SCH患病率混合高脂血症最高,差异有统计学意义(P<0.05);将以上对比有差异的影响因素进行多因素Logistic回归分析发现性别、年龄、SP、TC、FBG、2hPG均为影响脂代谢异常人群患SCH的独立因素。结论脂代谢异常与SCH疾病发生之间有紧密联系,患病情况在女性、高龄患者中更突出,血脂可能在一定程度上影响甲状腺激素的分泌,最终引发SCH,因此临床需重视相关因素并进行防治。 展开更多
关键词 脂代谢异常 亚临床甲状腺功能减退 血脂 血糖 甲状腺激素
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甲状腺功能亢进及甲状腺功能减退诱发老年骨质疏松的机制分析
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作者 刘瑶 秦迪 +3 位作者 刘东明 王岩 陈雷 黄丽红 《中国实验诊断学》 2024年第3期312-318,共7页
目的通过对生信数据的挖掘来探究甲状腺功能亢进及甲状腺功能减退与老年骨质疏松之间的关联及治疗靶点。方法通过GEO数据库去挖掘老年骨质疏松症的差异表达基因,以及借助人类疾病数据库筛选骨质疏松、甲亢及甲减的靶基因。将上述基因整... 目的通过对生信数据的挖掘来探究甲状腺功能亢进及甲状腺功能减退与老年骨质疏松之间的关联及治疗靶点。方法通过GEO数据库去挖掘老年骨质疏松症的差异表达基因,以及借助人类疾病数据库筛选骨质疏松、甲亢及甲减的靶基因。将上述基因整合映射后分别得出老年骨质疏松与甲亢、甲减的交集靶点基因。借助STRING数据库构建PPI网络,并且应用Cytoscape软件进行关键基因的筛选。通过R软件进行功能富集分析。结果老年骨质疏松分别与甲亢及甲减匹配映射得到67和126个交集靶点基因。PPI网络构建得出TNF、AKT1、ALB、CD4、IL2等关键基因可能与老年骨质疏松合并甲亢相关,并且受到Ⅰ型糖尿病、糖尿病并发症中的AGE-RAGE信号通路、人类T细胞白血病病毒Ⅰ型感染、移植物抗宿主病、EGFR酪氨酸激酶抑制剂耐药性等信号通路的调节;ALB、AKT1、TP53、TNF、CTNNB1等关键基因可能与老年骨质疏松合并甲减相关,并受到糖尿病并发症中的AGE-RAGE信号通路、T17细胞分化、人类T细胞白血病病毒Ⅰ型感染、癌症中的蛋白聚糖、人巨细胞病毒感染等信号通路调节。结论TNF、AKT1、ALB、CD4、IL2可能为老年骨质疏松和甲亢共病机制的基础,ALB、AKT1、TP53、TNF、CTNNB1可能为老年骨质疏松和甲减共病机制的基础。上述发现可能为进一步探究甲亢及甲减诱发老年骨质疏松发病机制和治疗机制提供新的思路。 展开更多
关键词 老年骨质疏松 甲状腺功能亢进 甲状腺功能减退 生物信息学
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假性甲状旁腺功能减退症Ⅰb型合并亚临床甲状腺功能减退症1例报告及文献复习
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作者 郑文静 江黎晨 +3 位作者 张楠 章诗琪 薛丽萍 胡红琳 《安徽医药》 CAS 2024年第4期760-764,I0003,共6页
目的 报道1例临床诊断为假性甲状旁腺功能减退症(PHP)Ⅰb型合并亚临床甲状腺功能减退症病人临床资料,利用基因检测明确诊断并进行文献复习。方法 分析安徽医科大学第一附属医院内分泌科于2022年3月31日收治的1例以反复双下肢搐搦、乏力... 目的 报道1例临床诊断为假性甲状旁腺功能减退症(PHP)Ⅰb型合并亚临床甲状腺功能减退症病人临床资料,利用基因检测明确诊断并进行文献复习。方法 分析安徽医科大学第一附属医院内分泌科于2022年3月31日收治的1例以反复双下肢搐搦、乏力为主诉病人的临床特征、实验室辅助检查结果并完善基因全外显子组测序(whole-exome sequencing,WES)。检索国内外假性甲状旁腺功能减退症Ⅰb型合并亚临床甲状腺功能减退症相关文献并总结其临床特点及基因突变类型。结果病人临床表现以反复双下肢搐搦及乏力为特征,实验室检查结果提示低血钙、高血磷、高甲状旁腺激素及高促甲状腺激素,全外显子基因测序结果表明GNAS复合体基因上游220 kb处突出融合蛋白16(STX16)基因exon5-6杂合缺失及GNAS A/B甲基化异常,结合该病人的临床资料及基因检测结果诊断为假性甲状旁腺功能减退症Ⅰb型合并亚临床甲状腺功能减退症。结论 对临床无法解释的复发性重度低钙血症病例应考虑罕见病PHP可能,而PHP合并亚临床甲状腺功能减退时因两者潜在关联性应及早对病人及家属进行基因检测以明确诊断并个性化治疗。 展开更多
关键词 假性甲状旁腺功能减退症 亚临床甲状腺功能减退 低钙血症 STX16基因 诊断
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孟德尔随机化研究溃疡性结肠炎与甲状腺功能减退发生风险的因果关系
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作者 花胤 王晓燕 +2 位作者 王振 辛永宁 刘守胜 《实用医学杂志》 CAS 2024年第6期827-832,共6页
目的 运用两样本孟德尔随机化(two sample mendelian randomization, TSMR)评估溃疡性结肠炎(ulcerative colitis, UC)与甲状腺功能减退(hypothyroidism, HT)之间的双向因果关系。方法 UC与HT相关的单核苷酸多态性位点(single nucleotid... 目的 运用两样本孟德尔随机化(two sample mendelian randomization, TSMR)评估溃疡性结肠炎(ulcerative colitis, UC)与甲状腺功能减退(hypothyroidism, HT)之间的双向因果关系。方法 UC与HT相关的单核苷酸多态性位点(single nucleotide polymorphism, SNP)数据分别来自芬兰生物银行和IEU数据库,提取出与UC强相关的独立SNP作为工具变量,采用逆方差加权法(inverse variance weighted,IVW)、Egger回归法(MR-Egger)、中位数加权法(weighted median)评估UC与HT之间的因果关联,同时采用MR-PRESSO评估水平多效性及离群的SNP,Cochran′s Q检测及漏斗图(funnel test)评估SNPs中的异质性,留一法分析(leave one out)是否存在单个SNP能够影响因果评估的结果。结果 筛选出4个与UC强相关关联的工具变量,IVW法提示UC和HT之间存在因果关系(OR=0.975,95%CI:0.924~0.990,P=0.011),Cochran Q检验Q=2.566,P=0.463,提示SNP之间不存在异质性。MR-Egger法(P=0.523)和MR-PRESSO法(P=0.548)均提示不存在水平多效性,反向TSMR的结果不支持反向因果关系。结论 TSMR发现UC与HT之间存在负向因果关系。 展开更多
关键词 溃疡性结肠炎 甲状腺功能减退 孟德尔随机化
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桥本甲状腺炎患者尿碘水平的分析
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作者 李晓蝶 徐永霞 +5 位作者 王芬 郭文露 贾伟 王雪锋 郎烺 朱德发 《安徽医科大学学报》 CAS 2024年第1期144-148,共5页
目的分析桥本甲状腺炎(HT)患者尿碘水平的差异,探讨不同碘营养状况下尿碘水平与HT可能存在的关系,为HT患者合理摄碘提供参考。方法选取入院就诊的HT患者101例为HT组,依据甲状腺功能分为3组:HT合并甲状腺功能亢进组41例;HT合并甲状腺功... 目的分析桥本甲状腺炎(HT)患者尿碘水平的差异,探讨不同碘营养状况下尿碘水平与HT可能存在的关系,为HT患者合理摄碘提供参考。方法选取入院就诊的HT患者101例为HT组,依据甲状腺功能分为3组:HT合并甲状腺功能亢进组41例;HT合并甲状腺功能正常组25例;HT合并甲状腺功能减退组35例。另外,选取健康体检者30例为对照组。采用化学发光法检测血清促甲状腺激素(TSH)、三碘甲状腺原氨酸(T_(3))、甲状腺素(T_(4))、甲状腺过氧化物酶抗体(TPOAb)及甲状腺球蛋白抗体(ATG)水平;超声诊断仪检查甲状腺器官的大小及形态结构;砷铈催化分光光度法检测尿碘水平。根据尿碘水平将人群碘营养状况分为碘缺乏(<100μg/L)、碘适宜(100~199μg/L)、碘足量(200~299μg/L)、碘过量(≥300μg/L)。采用非参数检验比较HT组与对照组尿碘水平差异,单因素方差分析、t检验比较HT分组与对照组尿碘水平差异及Spearman相关分析不同碘营养状况下尿碘水平与T_(3)、T_(4)、TSH、ATG、TPOAb的相关性。结果与对照组比较,HT组ATG、TPOAb水平升高(P<0.001),尿碘水平升高(P<0.05),差异有统计学意义;不同甲状腺功能状态下HT分组与对照组尿碘水平比较,仅HT合并甲状腺功能减退组升高(P<0.01),差异有统计学意义;Spearman相关分析显示总纳入对象中碘过量状况下尿碘水平与ATG、TPOAb水平呈正相关(P<0.05),HT患者中碘足量、碘过量状况下尿碘水平与TSH水平呈正相关(P<0.05)。结论HT患者尿碘水平较正常人偏高。居民尿碘水平≥300μg/L时,摄碘易发生HT;HT患者尿碘水平≥200μg/L时,摄碘易发生甲状腺功能减退,需限制碘摄入。 展开更多
关键词 尿碘 碘营养 碘过量 桥本甲状腺炎 甲状腺功能减退 相关性
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Zeste同源物2增强子在桥本甲状腺炎B淋巴细胞亚群中的表达及其抑制剂的治疗机制及效果研究
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作者 易圣果 曹业迪 +9 位作者 赵雪 卢桂芝 张杨 丛铁川 张澜波 张继新 梁振威 屈晨雪 张俊清 高莹 《中国全科医学》 CAS 2024年第21期2639-2645,共7页
背景甲状腺自身抗体是诊断桥本甲状腺炎(HT)的标志,B淋巴细胞在HT的发病机制中发挥重要作用。Zeste同源物2增强子(EZH2)是一种表观遗传学蛋白,在淋巴细胞的发育与功能调控中扮演重要角色。目的本研究探讨EZH2在HT甲状腺组浆母细胞及浆... 背景甲状腺自身抗体是诊断桥本甲状腺炎(HT)的标志,B淋巴细胞在HT的发病机制中发挥重要作用。Zeste同源物2增强子(EZH2)是一种表观遗传学蛋白,在淋巴细胞的发育与功能调控中扮演重要角色。目的本研究探讨EZH2在HT甲状腺组浆母细胞及浆细胞中的表达,进一步探讨EZH2抑制剂在实验性自身免疫甲状腺炎(EAT)模型中的治疗作用。方法收集北京大学第一医院2010—2020年6例行甲状腺手术的患者,取肿瘤对侧的甲状腺组织(HT及正常甲状腺组织各3例),通过RNA-seq筛选B淋巴细胞相关基因的表达情况;收集16例HT患者的甲状腺组织和8例健康对照(HD)甲状腺组织,分别利用免疫组化及免疫荧光验证EZH2在HT甲状腺组织中B淋巴细胞中的表达;收集25例HT甲状腺细针穿刺液(FNA)、19例HT外周血以及12例健康人外周血样本应用流式细胞分析检测EZH2在浆母细胞及浆细胞中的表达改变。将15只7周龄NOD.H-2^(h4)小鼠EAT模型分为对照组(n=5)、EAT无注射(n=5)或注射EZH2抑制剂GSK126处理组(10 mg/kg,腹腔注射3次/周,n=5),8周后观察甲状腺炎症程度及甲状腺球蛋白抗体(TgAb)水平的改变。结果RNA-seq结果显示,相较于正常甲状腺组织,HT甲状腺组织中EZH2水平上调,一些与B淋巴细胞表型相关的基因例如CD19、CD27、CD38、CD52相应增加。免疫组化结果显示,16例HT甲状腺组织标本中EZH2免疫组化染色均可在生发中心(GC)见到阳性细胞,呈强阳性,8例正常甲状腺组织染色中未观察到阳性细胞。HT甲状腺组织中EZH2染色高表达在GC区,EZH2特异性地表达在CD_(19)^(+)B淋巴细胞中。流式细胞术检测结果显示HT FNA样本中CD_(19)^(+)B淋巴细胞、浆母细胞及浆细胞比例均高于HD外周血、HT外周血样本(P<0.01),HT FNA样本中EZH2在CD_(19)^(+)B淋巴细胞、浆母细胞中的阳性比例高于HT外周血(P<0.005)。小鼠实验中,EAT组甲状腺的淋巴细胞浸润较对照组增加。GSK126处理组炎症程度评分和TgAb水平高于对照组,低于EAT组(P<0.001)。结论EZH2在HT甲状腺组织CD_(19)^(+)B淋巴细胞中表达异常升高,可能促进了B淋巴细胞分化成浆细胞进而促进自身抗体生成破坏甲状腺,EZH2抑制剂可以减缓EAT模型甲状腺炎症程度。浆母细胞中EZH2表达增加可能参与了HT的发病机制,EZH2可能成为治疗HT的新靶点,相关机制需要进一步深入研究。 展开更多
关键词 桥本甲状腺炎 B淋巴细胞亚群 Zeste同源蛋白2增强子 甲状腺功能减退症 靶向治疗
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