[1]贾超翼,乔立,史嘉琪,等.甲状腺激素治疗亚临床甲状腺功能减退症对血脂水平影响的荟萃分析[J].国际放射医学核医学杂志,2016,40(5):350-356.[doi:10.3760/cma.j.issn.1673-4114.2016.05.005]
　Jia Chaoyi,Qiao Li,Shi Jiaqi,et al.Effect of L-thyroxine versus placebo treatment on serum lipid levels in subclinical hypothyroidism[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(5):350-356.[doi:10.3760/cma.j.issn.1673-4114.2016.05.005]
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甲状腺激素治疗亚临床甲状腺功能减退症对血脂水平影响的荟萃分析(/HTML)
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《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
40
期数:
2016年第5期
页码:
350-356
栏目:
论著
出版日期:
2016-09-25

文章信息/Info

Title:
Effect of L-thyroxine versus placebo treatment on serum lipid levels in subclinical hypothyroidism
作者:
贾超翼1;  乔立1;  史嘉琪1;  兰晓莉2
1. 430030 武汉, 华中科技大学同济医学院临床医学系;
2. 430022 武汉, 华中科技大学同济医学院附属协和医院核医学科
Author(s):
Jia Chaoyi1;  Qiao Li1;  Shi Jiaqi1;  Lan Xiaoli2
1. Department of Clinical Medicine, Tongji Medicial College, Huazhong University of Science and Technology, Wuhan 430030, China;
2. Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
关键词:
甲状腺激素类; 随机对照试验; Meta分析; 亚临床甲状腺功能减退症; 血脂
Keywords:
Thyroid hormones; Randomized controlled trials; Meta-analysis; Subclinical hypothyroidism; Serum lipids
DOI:
10.3760/cma.j.issn.1673-4114.2016.05.005
摘要:
目的 使用荟萃分析方法汇总随机对照试验，评估甲状腺激素对亚临床甲状腺功能减退症（SCH）患者血脂水平的影响。方法 以“thyroxine”、“ levothyroxin”及“levothyroxine”为关键词检索了2015年7月前包括Cochrane Library、PubMed、Medline、Google Scholar及Embase等在内的数据库中有关甲状腺激素替代治疗SCH的随机对照试验文献，所有数据均为连续型变量，采用Cochrane提供的RevMan 5.2软件进行统计学分析，依据Cochrane质量评价标准进行文献质量评估。当研究间存在异质性时（I2>50%），采用随机效应模型进行荟萃分析；否则采用固定效应模型进行荟萃分析。结果 最终纳入7篇随机对照试验文献，共319例患者。纳入的7篇文献方法学整体质量较好。共进行4组荟萃分析评价甲状腺激素对血脂的影响，4组研究之间无统计学异质性[总胆固醇（TC）：I2=42%，P=0.11；甘油三酯（TG）：I2=0，P=0.92；低密度脂蛋白胆固醇（LDL-C）：I2=34%，P=0.18；高密度脂蛋白胆固醇（HDL-C）：I2=0，P=0.96]，均采用固定效应模型进行荟萃分析。荟萃分析结果显示，甲状腺激素及安慰剂对血浆中血脂水平的影响程度如下：TC（平均差：-0.18；95% CI：[-0.40，0.03]；P=0.09）、TG（平均差：-0.02；95% CI：[-0.17，0.13]；P=0.78）、LDL-C（平均差：-0.23；95% CI：[-0.44，-0.33]；P=0.02）、HDL-C（平均差：-0.06；95% CI：[-0.14，0.02]；P=0.14）。结论 对于SCH患者，在进行外源性甲状腺激素治疗后，血浆LDL-C水平得到改善，而血浆TC、TG、HDL-C水平未见明显变化。
Abstract:
Objective Subclinical hypothyroidism is a common disease. However, whether L-thyroxine replacement treatment can affect serum lipids in cases of subclinical hypothyroidism remains controversial. The objective of this meta-analysis was to assess the effect of L-thyroxine therapy on serum lipid levels of patients with subclinical hypothyroidism. Methods Literature dated until July 2015 was retrieved from the Cochrane Library, PubMed, Medline, Google Scholar, and Embase searching for the keywords "hyroxine", "levothyroxin" and "levothyroxine". All randomized controlled trials(RCTs) to determine the effects of L-thyroxine replacement on serum lipid levels were included in this study. After screening, the eligible RCTs were included in this meta-analysis. Statistical analyses were performed by the Review Manager 5.2 software. All the assessed outcomes were continuous data. Results A total of 7 RCTs involving 319 patients were included. The overall methodological quality of the RCTs was good. Results showed that the serum low density lipoprotein-cholesterol(LDL-C) level significantly decreased after L-thyroxine treatment[mean difference(MD):-0.23; 95% CI:[-0.44, -0.03]; P=0.02]. Meanwhile, changes in the total cholesterol(MD:-0.18; 95% CI:[-0.40, 0.03]; P=0.09), triglyceride(MD:-0.02; 95% CI:[-0.17, 0.13]; P=0.78), and high density lipoprotein-cholesterol(MD:-0.06; 95% CI:[-0.14, 0.02]; P=0.14) levels were not significant. Conclusion s All available RCT evidence on the effect of L-thyroxine on serum lipid levels in subclinical hypothyroidism revealed a significant improvement in the serum LDL-C levels. However, the serum TC, TG, and HDL-C levels did not significantly change.

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备注/Memo

备注/Memo:
收稿日期:2016-05-27
通讯作者:兰晓莉,Email:hzslxl@163.com
更新日期/Last Update: 1900-01-01