胆汁酸代谢产物与Graves病患者甲状腺功能的相关性探讨

Correlation between bile acid metabolites and thyroid function in patients with Graves disease

  • 摘要:
      背景  甲亢会影响胆汁酸的代谢过程,但具体影响方式和结果尚未完全阐明,各项研究结果也不一致。
      目的  探讨胆汁酸代谢产物与Graves病患者甲状腺功能的相关性。
      方法  纳入2018年11月- 2019年11月在北京朝阳医院内分泌科就诊的初发、未治疗的Graves病患者39例,其中男性13例,女性26例人,平均年龄(43.87 ± 4.46)岁。另选择年龄、性别和体质量指数(body mass index,BMI)匹配的健康对照者39例。比较病例组与对照组胆汁酸水平差异,并利用Spearman检验进行差异胆汁酸代谢物浓度与甲状腺功能的相关性分析。
      结果  与正常对照组相比,Graves病患者血清牛磺胆酸(taurocholic acid,TCA)、牛磺熊脱氧胆酸(tauroursodeoxycholic acid,TUDCA)和牛磺α鼠胆酸(tauro-alpha-muricholic acid,T-alpha-MCA)水平升高,甘氨脱氧胆酸(glycodeoxycholic acid,GDCA)、鹅脱氧胆酸(chenodeoxycholic acid,CDCA)、脱氧胆酸(deoxycholic acid,DCA)、石胆酸(lithocholic acid,LCA)、猪脱氧胆酸(hyodeoxycholic acid,HDCA)和牛磺脱氧胆酸(taurodeoxycholic acid,TDCA)水平降低(P<0.05)。其余种类的胆汁酸血清水平在两组间无统计学差异。Spearman相关性分析发现,病例组FT3水平与DCA(r=-0.379,P=0.039)、HDCA(r=-0.486,P=0.006)和CDCA(r=-0.361,P=0.046)均呈显著负相关,与TUDCA呈显著正相关(r=0.340,P=0.042);FT4水平与CDCA(r=-0.408,P=0.023)、DCA(r=-0.427,P=0.019)、GDCA(r=-0.371,P=0.048)和HDCA(r=-0.447,P=0.012)均呈显著负相关。
      结论  Graves病患者血清中部分胆汁酸成分的浓度发生改变,并与FT3和FT4水平的变化相关联。

     

    Abstract:
      Background  Hyperthyroidism can affect the metabolic process of bile acid. However, the specific causes of this effect have not yet been fully elucidated and the results are inconsistent across studies.
      Objective  To explore the correlation between bile acid metabolites and thyroid function in patients with Graves disease.
      Methods  From November 2018 to November 2019, 39 Graves disease patients and 39 normal control subjects were enrolled after matching for age, sex and body mass index from Beijing Chaoyang Hospital, and the biological and clinical data were collected. Of the 39 Graves disease patients, there were 13 males and 26 females with average age of (43.87 ± 4.46) years. Differences of baseline clinical and biochemical measurements as well as levels of bile acids between Graves disease patients and healthy controls were evaluated using the independent sample t-test for normally distributed variables or the Mann-Whitney test for skewed distributed variables. Spearman correlation coefficients were calculated between serum bile acids and thyroid function parameters.
      Results  Significant increases in serum levels of taurocholic acid (TCA), tauro-ursodeoxycholic acid (TUDCA), tauro-α-muricholic acid (TαMCA), and significant decrease in serum levels of glycodeoxycholic acid (GDCA), chenodeoxycholic acid (CDCA), lithocholic acid (LCA), hyodeoxycholic acid (HDCA), deoxycholic acid (DCA), taurodeoxycholic acid (TDCA) were observed in Graves disease patients compared to healthy controls (all P <0.05). There was no statistically significant difference in other bile acids between the two groups(P >0.05). Spearman correlation analysis found that the level of FT3 in the case group was negatively correlated with DCA (r=-0.379, P=0.039), HDCA (r=-0.486, P=0.006) and CDCA (r=-0.361, P=0.046), and was positively correlated with TUDCA (r=0.340, P=0.042). And FT4 level was negatively correlated with CDCA (r=-0.408, P=0.023), DCA (r=-0.427, P=0.019), GDCA (r=-0.371, P=0.048) and HDCA (r=-0.447, P=0.012).
      Conclusion  Compared to the healthy patient, the concentration of different bile acids is remarkably changed in Graves patients’ serum, which are correlated with FT3 and FT4.

     

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