在不同甲状腺激素替代治疗的甲状腺功能低下症患者中逆转T3
Julian B Wilson1, Thanh D Hoang2, Martin L Lee1,3
1Division of Endocrinology, Metabolism and Molecular Medicine, Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, California, United States of America.
PloS one
|June 9, 2025
概括
在接受L-T4治疗的甲状腺功能低下患者中,反向T3 (rT3) 的升高是常见的. 仅用L-T4治疗的患者表现出最高的RT3水平,这表明这种治疗方法可能存在问题.
科学领域:
- 内分泌学 在内分泌学.
- 甲状腺激素替代疗法 甲状腺激素替代疗法
背景情况:
- 反向T3 (rT3) 是一种非活性甲状腺激素代谢物.
- 升高的rT3可能会阻碍活性T3与受体结合.
- 在接受L-T4治疗的患者中持续的疲劳需要对替代解释进行调查.
研究的目的:
- 为了调查持续疲劳的甲状腺功能低下患者中rT3升高的患病率.
- 为了在不同的甲状腺激素替代疗法中比较rT3水平.
主要方法:
- 对976名患有甲状腺功能低下症和疲劳的患者进行了回顾性分析.
- 对rT3,TSH,自由T3和自由T4的测量.
- 对于rT3而言LC/MS-MS,对于其他激素而言ECLIA.
主要成果:
- 仅用L-T4治疗的患者中有20.9%的RT3.3升高.
- 接受L-T4治疗的患者表现出较高的RT3水平,而不是那些没有替代治疗的患者 (p < 0.00001).
- rT3水平与自由T4和自由T3相关,与TSH相反.
结论:
- 在患有疲劳的甲状腺功能低下患者,特别是那些接受L-T4单疗法的患者中观察到升高的RT3.
- 单独的L-T4替代与最高的RT3水平有关.
- 含有L-T3的制剂显示了最低的RT3水平.
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