The Change Of Serum Resistin Concentration With The Thyroid Dysfunction

Objective: Thyroidrelated disease is a kind of common diseases inendocrine department, which is increasing significantly due to the change ofvarious aspects such as lifestyle,living condition,dietarystructurein in recentyears. Resistin is newly discovered as a kind of derived-adipocyte peptide, andits clinical effect is gradually being understanding. Some studies shows thatresistin may be linked to the disease process of obesity,insulinresistance,diabetes,atherosclerosis, inflam-mation and so on.At present,thereare less for researches of the relationship between resistin andthyroiddisease.In this study,we will observe the changes with serum resistin levels indifferent causes of thyroid disease and the relationship between resistin andthyroid hormone, thyroid-related antibodies,blood glucose,blood lipids,bodyfat and other facts，to further explore the impact of thyroid dysfunction onserum hormone levels.Methods:We choose four groups subjects to study, the normal controlsgroup wereselected from the Medical Examination Center in the SecondHospital of Hebei Medical University during September and October in2013,including male8cases and female16cases. Both of their thyroidfunction,thyroid antibodie,fasting blood glucose, and postprandial2hour’sblood glucose values,blood fat and thyroid ultrasonography are within thenormal range，and they have no thyroid disease or a history of otherautoimmune diseases.Research groups include the patients who are newlydiagnosed by the Endocrinology Department in the Second Hospital of HebeiMedical University，and all of them have the typical clinical symptoms.what’smore the course of disease are less than2months,and related medicationshave not been applied on them before.Group of Graves’Diseaseareautoimmune hyperthyroidism ones, including male8cases and female16 cases，who’s mean ages were (33.71±9.25) years old. Group of HashimotoThyroiditis are autoimmune hypothyroidism patients(contain clinicalhypothyroidism and subclinical hypothyroidism), which including30cases,male5cases and female25cases,who’s mean ages were (37.57±13.68) yearsold. Group of Subacute Thyroiditis is total of28cases, including male11cases and female17cases，who’s mean ages were（39.32±10.00）.The patientsin this group are pain Subacute thyroiditisones with a high state ofthyrotoxicosis.All of the volunteers do not have the history of diabetes,chronichypertension, coronary heart disease,cerebrovascular diseaseand or otherchronic medical history,while they are not associated with other autoimmunesystem, blood system dieases or malignant tumor history, and except for acuteand chronic infection, liver and kidney function damage.All subjects were recorded height, weight, and other general information,furthermore calculate the percentage of body fat,（BF%=(1.20×BMI)+(0.23×age)(10.8×sex)5.4，1for male and0for female）.They were collectedvenous blood save to-70℃refrigerator for measuring biochemicalindexes,thyroidfunction,fasting blood glucose.Except that,in GD group we collectedThyrotropin Receptor Antibody(TRAb) in additio-n,in ST group werecollected Erythrocyte Sedimentation Rate(ESR),High-Sensitivity C-reactiveProtein(HS-CRP) in addition，and HT group were collected Thyroglobulinantibody (TGAb) and Anti-thyroid Peroxidase Antibodies (TPoAb).Bloodresistinwas determined by ELISA double antibody sandwich.SPSS19.0statistical software is used to deal with all data. The data istested normally. According to the normal distribution of the data adoptmean±standard deviation, variance analysis comparing the selection amongmultiple groups, between the two groups was compared with S-N-K method;non-normal data using the median, four percentile interval representation,comparisons between groups using rank sum test. Spearman correlationanalysis between the two indexes by correlation, multiple regression analysisand non-conditional logistic regression analysis and multiple stepwiseregression analysis using. All tests were two-sided, P<0.05had statistical. Result:1Comparison between the age, weight, sex ratio, there were nosignificant differences between four groups (P>0.05). Pairwise comparison ofthe body fat percentage shows no significant difference between GD,SAT andNC group，but HT group were significantly higher than the three groupsabove(P<0.05).2Comparison of the thyroid functionin in the four groups, the levels ofFT3, FT4in GD and SAT group were significantly higher than NC group.InHT group，the levels of FT4was lower than NC group,(P<0.05), but there hasno significant difference in FT3between them(P>0.05).3Resistin comparison between the four groups:the levels of serumresistin in GD, SAT group were higher than that in NC and HT group,thedifference was statistically significant (P <0.05).Resistin levels in GD groupwas greater than those in the SAT group(P<0.05). Even though resistin levelsin HT group showed a trend of increase, but the difference was not statisticallysignificant (P>0.05).4Compartion of lipid between the four groups show that differences intriglyceride levels among the four groups was not statistically significant(P>0.05). Total cholesterol in group HT was higher than in group NC(P<0.05), group GD and SAT arelower than in group NC (P<0.05).Highdensity lipoprotein in GD and SAT group were lower than in NC group(P<0.05), while no significant difference between the HT and NC group (P>0.05).The low density lipoprotein was higher in group HT than in NC，andlower in GD group than that in NC，the difference between SAT and NCgroup was not statistically significant (P>0.05).5Compartion of blood glucose between the four groups show that thelevels in group GD and SAT were significantly higher than group NC andHT(P<0.05)，but the difference between GD and SAT group or NC and HTgroup was not statistically significant(P>0.05).6By Spearman correlation tests of all subjects,the level of serum resistinwas positively correlated with body fat percentage, FT3, FT4,GLU.While TSH,LDL,CHOL and HDL showed a negative correlation; There was nosignificant correlation with the rests.Compared with the overall，in GD group correlation analysis didn’t showcorrelation between resistin and glucose,blood lipids TPoAb,and TRAb;SATgroup shows that resistin were not correlate with blood glucose,bloodlipids,TSH,ESR,but was positively correlate with HS-CRP; HT groupshowed that only body fat percentage show positively correlated with resistin，and other factors not relevant.7By Multiple Stepwise Regression, FT3and body fat percentage weresignificantly affect on the levels of resistin in the whole,the regressioncoefficients and P values wer（e0.739,0.000）（,0.369,0.000）.Both in GD groupand SAT group,FT3and body fat percentage were significantly affect on thelevels of resistin,the regression coefficients and P values were （0.650,0.000）,（0.417,0.002）;（0.394,0.018）,（0.556,0.001）.In HT group body fatpercentage was significantly affect on the levels of resistin.There gressioncoefficients and P values were（0.437,0.016）.Conclusion:1This study discovered that the serum resistin levels will change whenthyroid dysfunction，serum resistin levels in patients suffering from Graves’disease hyperthyroidism or thyrotoxicosis periodof subacute thyroiditis areelevated；Its’levels in the patients of Hashimoto’s thyroiditis hypothyroidismshowed a trend of increase, but there is no significant difference with normalthyroid function status.2This study discovered that，in high blood thyroid hormone status,thelevel of resistin is positively correlated with FT3and FT4,and negativelycorrelated with TSH,the determining factor in the change of resistin is FT3.Butin hypothyroidism,there have no relationship between resistin and the indexesof thyroid function.3This study also shows that: serum resistin was positively correlatedwith body fat percentage, and it is also the determining factor in the levelchange of resistin,which indicating that resistin levels may be largely influenced by the body fat.4In our study, the serum resistindidn’t show any correlate withanti-thyroid antibodies in Graves’ disease and Hashimoto’s thyroiditis.However, resistin was positively correlated with HS-CRP in the patients ofsubacute thyroiditis, suggesting that the serum resistin may response to thebody’s inflammatory in some extent.