禁食与非禁食,在甲状腺功能下降症中调整剂量的levothyroxine摄入:一项随机临床试验
Jeresa I A Willems1, Daan J L van Twist1, Floris Helmich2
1Department of Internal Medicine, Zuyd Thyroid Center, Zuyderland Medical Center, Sittard/Heerlen, the Netherlands.
The Journal of clinical endocrinology and metabolism
|December 23, 2025
概括
与早餐一起服用levothyroxine (LT4),剂量增加15%,维持了甲状腺刺激激素 (TSH) 的稳定性,并改善了患者的福祉. 这种以患者为中心的方法为禁食的LT4摄入提供了一个可行的替代方案.
科学领域:
- 内分泌学 在内分泌学.
- 甲状腺疾病 甲状腺疾病
- 药理动力学 药理动力学
背景情况:
- 利沃甲状腺素 (LT4) 通常在空腹服用,以最大限度地吸收.
- 禁食摄入可能是不方便的,可能会降低患者对治疗的坚持.
- 患者偏好研究表明,人们对非禁食的LT4治疗有很大的兴趣.
研究的目的:
- 为了评估非禁食的LT4摄入的有效性,与15%的剂量调整,在维持甲状腺刺激激素 (TSH) 稳定性.
- 为了比较服用LT4与早餐的患者与在禁食状态下服用LT4的患者之间的TSH稳定性.
- 在两组研究中评估患者的幸福感和治疗偏好.
主要方法:
- 一项随机对照试验,涉及患有良好控制的甲状腺功能低下症的成年人.
- 参与者被分配到禁食的LT4摄入量或剂量调整的早餐LT4摄入量.
- 监测甲状腺激素水平 (TSH,FT4,TT3),根据需要调整剂量,以实现TSH稳定性.
主要成果:
- 在禁食 (74.4%) 和早餐 (73.3%) 组之间,TSH稳定性是可比的.
- 与早餐一起服用LT4的患者报告说,他们的健康状况有所改善,并且更倾向于非禁食摄入 (76.2%).
- 很高的比例 (88.9%) 的患者选择在研究后继续服用非禁食的LT4.
结论:
- 与15%的剂量增加一起,在早餐时服用勒沃西,有效地保持了TSH稳定性.
- 这种非禁食的方法提高了患者的福祉和坚持,与患者的偏好保持一致.
- 非禁食的LT4摄入代表了实用和以患者为中心的替代传统的禁食管理.
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