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首页> 外文期刊>Nepal Journal of Epidemiology >The Clinical Implications of Thyroid Hormones and its Association with Lipid Profile: A Comparative Study from Western Nepal
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The Clinical Implications of Thyroid Hormones and its Association with Lipid Profile: A Comparative Study from Western Nepal

机译：甲状腺激素的临床意义及其与脂质谱的关系：来自尼泊尔西部的比较研究

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BackgroundThyroid dysfunction is one of the major public health problems in Nepal. Laboratory tests facilitate early diagnosis before clinical features are obvious, increased sensitivity carries the price of decreased diagnostic specificity. Laboratory tests coupled with supportive clinical findings are frequently used to diagnose thyroid dysfunction. Historically, hypercholesterolemia and raised serum low density lipoprotein (LDL) cholesterol levels have been found to be associated with subclinical hypothyroidism. Therefore, assessment of altered lipid profile plays a supportive role in diagnosis of thyroid dysfunction. The aim of our study was to find out the variations of thyroid hormones and lipid profile in hyperthyroidism and hypothyroidism with their clinical implications.Materials and Methods It was a hospital based retrospective study carried out from the data retrieved from the register maintained in the Department of Biochemistry of the Manipal Teaching Hospital, Pokhara, Nepal between 1st July, 2009 and 30th June, 2010. The variables collected were age, gender, T4, T3, TSH, fT4, total cholesterol and triglyceride levels. Descriptive statistics and testing of hypothesis were used for the analysis of data.Results122 out of the 365 subjects selected for the study had some form of thyroid disorder. Of the 122 cases, 40 had hyperthyroidism, 42 had hypothyroidism and the remaining 40 were diagnosed to have subclinical hypothyroidism. The frequency of thyroid disorders was much higher in females as compared to their male counterparts. The mean value of each variable in cases, except for age, was statistically significant as compared to controls (p=0.001). Elevated levels of total T3 (CI 2.14 to 2.59), T4 (CI 13.00 to 15.30) and fT4 (CI 2.51 to 2.81) associated with decreased TSH levels (CI 0.29 to 0.35) were found in cases of hyperthyroidism. The TSH values (CI 17.05 to 22.85) were markedly increased while T4 and T3 values were found to be less than the reference range in cases of hypothyroidism. There was significant increase in the mean concentration of total cholesterol (CI 268.83 to 289.79) and triglycerides (CI 154.81to 182.05) in cases of hypothyroidism. The fT4 (CI 1.08 to 1.22) levels were in reference range and TSH levels (CI 9.59 to 10.50) were moderately raised in cases of subclinical hypothyroidism.ConclusionThyroid dysfunction is common across all age groups and shows a strong female preponderance in Pokhara valley. It necessitates the measurement of thyroid hormones in women after the age of 50, in pregnancy and after delivery, and in women and men with hypercholesterolemia. Therefore, timely screening and check ups are necessary in order to curtail the problem of undiagnosed cases, giving specific consideration to patients who have high artherogenic profile. This will reduce the risk of future negative health events in older adults.
机译：背景甲状腺功能障碍是尼泊尔的主要公共卫生问题之一。实验室检查有助于在临床特征明显之前进行早期诊断，灵敏度的提高会降低诊断特异性。实验室检查加上支持性临床发现常用于诊断甲状腺功能障碍。从历史上看，高胆固醇血症和血清低密度脂蛋白（LDL）胆固醇水平升高与亚临床甲状腺功能减退有关。因此，评估血脂变化对甲状腺功能障碍的诊断起辅助作用。本研究的目的是发现甲亢和甲状腺功能减退症中甲状腺激素和脂质谱的变化及其临床意义。材料与方法这是一项基于医院回顾性研究，其资料来自于美国国立卫生部皮肤科登记册。 2009年7月1日至2010年6月30日之间，尼泊尔博克拉市Manipal教学医院的生物化学。收集的变量包括年龄，性别，T4，T3，TSH，fT4，总胆固醇和甘油三酸酯水平。使用描述性统计数据和假设检验进行数据分析。结果从365名研究对象中选择122名患有某种形式的甲状腺疾病。在122例中，有40例患有甲亢，42例患有甲状腺功能低下，其余40例被诊断为亚临床甲状腺功能减退。与男性相比，女性的甲状腺疾病发生率要高得多。与年龄相比，病例中每个变量的平均值（与年龄相比）均具有统计学意义（p = 0.001）。在甲亢患者中，总T3（CI 2.14至2.59），T4（CI 13.00至15.30）和fT4（CI 2.51至2.81）升高与TSH水平降低（CI 0.29至0.35）相关。在甲状腺功能减退的情况下，TSH值（CI 17.05至22.85）显着增加，而T4和T3值则小于参考范围。在甲状腺功能减退的情况下，总胆固醇（CI 268.83至289.79）和甘油三酸酯（CI 154.81至182.05）的平均浓度显着增加。亚临床甲状腺功能减退症患者的fT4（CI 1.08至1.22）水平在参考范围内，TSH水平（CI 9.59至10.50）适度升高。结论甲状腺功能障碍在所有年龄段均常见，在博卡拉谷地女性中占优势。它需要对50岁以上的女性，怀孕和分娩后以及高胆固醇血症的女性和男性中的甲状腺激素进行测量。因此，为了减少未确诊病例的问题，必须及时进行筛查和检查，尤其要考虑那些具有高动脉粥样硬化特征的患者。这将减少老年人将来发生负面健康事件的风险。

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