标题：甲状腺功能异常患者营养和血脂的相关性研究

      作者：刘建辉，曾韵仪，卓伟，吕伟标    南方医科大学顺德医院佛山市顺德区第一人民医院检验科，广东 顺德 528300

      卷次： 2019年30卷10期

      【摘要】 目的 探讨甲状腺功能异常患者营养和血脂的相关性。方法 选取2016年1月至2018年2月期间在佛山市顺德区第一人民医院内分泌科住院治疗的183例甲状腺功能异常患者作为研究对象，选择同期40例在我院体检中心体检的健康者作为对照组，根据甲状腺激素的参考值把甲状腺功能异常患者分为甲状腺功能亢进组(甲亢组) 139例和甲状腺功能减退组(甲减组) 44例。比较三组受检者白蛋白(ALB)、总蛋白(TP)的差异；各组TP与甘油三酯 (TG)、胆固醇 (TC)、高密度脂蛋白 (HDL-C)、低密度脂蛋白 (LDL-C)的相关性；各组 ALB与 TG、TC、HDL-C、LDL-C的相关性。结果 甲亢组和甲减组患者的ALB分别为(43.68±5.72) g/L和 (43.62±5.15) g/L，均明显低于对照组的(46.08±4.13) g/L，差异均具有统计学意义(P<0.05)；甲亢组患者的 TC、HDL-C和 LDL-C分别为(5.61±2.02) mmol/L、(1.36±0.38) mmol/L、(2.22±0.68) mmol/L，均明显低于对照组的 (5.22±0.92) mmol/L、(1.49±0.34) mmol/L、(3.08±0.70) mmol/L，差异均具有统计学意义(P<0.05)；甲减组患者的TG为(1.43±0.97) mmol/L，明显高于对照组的(1.09±0.66) mmol/L，差异具有统计学意义(P<0.05)；Spearman相关性分析结果显示，甲亢组患者的ALB与TC、HDL-C和LDL-C呈正相关(r值分别为 0.349、0.449、0.147，P<0.05)；TP与TC、TG和HDL-C呈正相关(r值分别为0.338、0.174、0.149，P<0.05)。结论 甲状腺功能异常可导致血清中白蛋白和血脂水平改变，甲状腺功能亢进患者的ALB随TC、HDL-C、LDL-C的降低而下降，TP随TC、TG、HDL-C的降低而下降。
      【关键词】 甲状腺功能异常；白蛋白；总蛋白；血脂代谢；相关性
      【中图分类号】 R581 【文献标识码】 A 【文章编号】 1003—6350（2019）10—1280—04

Relationship between nutrition and blood lipids in patients with thyroid dysfunction.
LIU Jian-hui, ZENG Shao-yi,ZHUO Wei, LV Wei-biao. Department of Clinical Laboratory, Shunde Hospital of Southern Medical University (the FirstPeople's Hospital of Shunde District of Foshan), Shunde 528300, Guangdong, CHINA
【Abstract】 Objective To investigate the relationship between nutrition and blood lipids in patients with thy-roid dysfunction. Methods A total of 183 patients with thyroid dysfunction who were hospitalized in the Departmentof Endocrinology at the First People's Hospital of Shunde District of Foshan from January 2016 to February 2018 wereselected as subjects. Forty healthy subjects who underwent physical examination at the physical examination center atour hospital were selected as the control group. According to the reference value of thyroid hormone, thyroid dysfunctionpatients were divided into thyroid hyperactivity group (hyperthyroidism group, n=139) and thyroid hypofunction group(hypothyroidism group, n=44). The differences in albumin (ALB) and total protein (TP) between the three groups werecompared. The correlation between TP and triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol (LDL-C) in each group were analyzed, as well as the correlation betweenALB and TG, TC, HDL-C, LDL-C in each group. Results The ALB of patients with hyperthyroidism and hypothyroid-ism were (43.68±5.72) g/L and (43.62±5.15) g/L, respectively, which were significantly lower than (46.08±4.13) g/L ofthe control group; both differences were statistically significant (P<0.05). The TC, HDL-C and LDL-C of the hyperthy-roidism group were respectively (5.61±2.02) mmol/L, (1.36±0.38) mmol/L and (2.22±0.68) mmol/L, which were signifi-cantly lower than corresponding (5.22±0.92) mmol/L, (1.49±0.34) mmol/L and (3.08±0.70) mmol/L of the control group;all differences were statistically significant (P<0.05). The TG in the hypothyroidism group was (1.43 ± 0.97) mmol/L,which was significantly higher than (1.09±0.66) mmol/L in the control group (P<0.05). Spearman correlation analysisshowed that ALB in the hyperthyroidism group was positively correlated with TC, HDL-C and LDL-C (r values were re-spectively 0.349, 0.449, 0.147, P<0.05), and TP was positively correlated with TC, TG and HDL-C (r values were respec-tively 0.338, 0.174, 0.149, P<0.05). Conclusion Thyroid dysfunction can lead to changes in serum albumin and bloodlipid levels. The ALB of patients with hyperthyroidism decrease with the decline of TC, HDL-C and LDL-C, and the TPdecrease with the decline of TC, TG and HDL-C.
      【Key words】 Thyroid dysfunction; Albumin; Total protein; Lipid metabolism; Correlation