The Effect Of Thyroid-stimulating Hormone Suppressive Therapy On The Lipid Profile In Patients After Surgery For Thyroid Cancer

Objective :To analyze the effect of thyroid-stimulating hormone suppressive therapy on the lipid profile among patients after surgery for thyroid cancer by postoperative follow-up,as well as the role of gender and menopause on that effect.And to explore the effects of gender and menopause on blood lipids under this therapy.Methods:Through the postoperative follow-up among patients who received thyroid surgery therapy in the department of thyroid surgery,China-Japan Union hospital,Jilin University in 2008-2011,clinical data were obtained.All possibilities that may affect blood lipids,for example,systemic diseases,drug-using history,long history of alcohol and tobacco,and bad compliance,were excluded out of this study.At last,Totally 145 patients were enrolled in this study.We collected patients' information of gender,age,height,weight,related medical history,and tested thyroid function and blood lipids,including serum thyroid stimulating hormone(TSH),three free iodine free triiodothyronine(FT3),free thyroxine(FT4),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C).According to TSH-inhibited degree patients were divided into four groups which were TSH < 0.1m IU/L group,0.1m IU/L ? TSH<0.372 m IU/L(lower limits of normal TSH)group,0.372 m IU/L ? TSH < 2.0m IU/L group and TSH ? 2.0m IU/L group.Meanwhile patients were divided into two groups according to the time of postoperative TSH suppressive therapy which were 3?TSH<5 years group and 5?TSH<8 years group.Patients were also divided by gender and menopausal status separately.SPSS 19.0 software were used for statistical analysis and to analyze the degree and time effect of TSH suppressive therapy on lipid profile and the differences of gender and menopause in that effect.We also explored the gender and menopausal effects on blood lipids under the therapy of TSH suppression.Results:1.The correlation between TSH suppressive therapy and lipid profile: TSH is significantly positively related to TC and LDL-C;FT3 is significantly negatively related to TC and LDL-C;The LDL-C level in TSH?2.0 m IU/L group is significantly higher than that in 0.372 m IU/L?TSH<2.0m IU/L group;There is no obvious correlation between TSH?FT3 and TG,HDL-C,or LDL/HDL,so is FT4 and lipid profile.2.The correlation between TSH suppressive therapeutical time and lipid profile: TSH suppressive therapy time and TG are significantly positively related;The level of TG in5?TSH<8 years group is significantly higher than that in 3?TSH<5 years group;There is no obvious correlation between treatmeant time and TC,HDL-C,LDL-C or LDL/HDL.3.There exists significant negative correlation in females between the degree of TSH suppressive therapy and total cholesterol,LDL-C,and significant positive correlation between the time of TSH suppressive therapy and triglyceride levels.Those two relations are not observed among males.There exists significant negative correlation in postmenopausal females between the degree of TSH suppressive therapy and total cholesterol,LDL-C,and significant positive correlation between the time of TSH suppressive therapy and triglyceride,LDL/HDL levels.Those two relations above are not observed among non-postmenopausal females.4.The effect of gender and postmenopausal differences on lipid profile during TSH suppressive therapy: Levels of TG and LDL/HDL in males are significantly higher than those in females;HDL-C level has the opposite situation.Levels of TC,TG,HDL-C,LDL-C and LDL/HDL levels in postmenopausal females are significantly higher than those in non-postmenopausal females.Conclusion:1.TSH suppressive therapy after thyroid surgery can improve the levels of TC and LDL-C,which is more obvious around the point of TSH value = 2 m IU/L;2.The time of TSH suppressive therapy after thyroid surgery has an effect on the level of triglyceride;3.The correlation between TSH suppressive therapy and lipid profile in females is more obvious than that in males.The correlation between TSH suppressive therapy and lipid profile in postmenopausal females is more obvious than that in males.4.During TSH suppressive therapy,gender and postmenopause has an effect on lipid profile.