The Correlation Between TSH Levels And Blood Lipids In Male IHH Patients

BackgroundIdiopathic hypogonadotropic hypogonadism?IHH?is a kind of diseases which caused by congenital or acquired unknown causes,leading hypothalamic secretion of gonadotropin releasing hormone?GnRH?or pituitary secretion of luteinizing hormone?LH?and follicular stimulating hormone?FSH?levels reduced,and then leading to hypogonadism.In these patients,A patient with olfactory dysfunction or olfactory insufficiency is defined as Kallmann syndrome?KS?,and a patient with a normal olfactory state is defined as nIHH.Long-term lack of gonadal hormone in patients with IHH often causes homeostasis imbalance and metabolic abnormalities.Studies have shown that patients with long-term low testosterone levels have high blood lipid levels.It has been found that testosterone can activate lipoprotein lipase?LPL?in the liver,and then promot free fatty acid?FFA?transport to the periphery,thereby reduce the synthesis of total cholesterol?TC?and low-density lipoprotein cholesterol?LDL-C?.Someone have proposed hypogonadism-obesity cycle hypothesis,consider Obesity can damage testosterone levels,low serum testosterone level promotes fat deposition.Up to now,the net mechanism of testosterone on blood lipids has not been fully confirmed,and previous studies are mostly in elderly patients,young patients have few been studied.The effect of low testosterone level on blood lipids is still not judged in IHH patients.The hypothalamic-pituitary-thyroid axis?HPT axis?is essential for regulating and maintaining homeostasis.Thyroid stimulating hormone?TSH?can also regulate lipid metabolism in a variety of ways,including acting on Thyroid stimulating hormone receptor?TSHR?,affecting lipid metabolism-related enzyme expression,and affecting certain lipid metabolism.Expression of immune factors,etc.A large number of studies have shown that TSH is significantly associated with blood lipids in patients with hypothyroidism and subclinical hypothyroidism.Later studies have shown that the blood lipid levels between different TSH levels within the normal range are obviously different.IHH patients can be low testosterone itself,which has an effect on blood lipids.Whether the regulation of TSH further affects lipid metabolism is unknown.Whether there is a cross-effect between TSH and low testosterone is worthy of discussion.Therefore,this study is to study the differences in blood lipids between different TSH levels in the normal range of male IHH patients,to explore the related factors of blood lipids in patients with IHH,and to provide new ideas for clarifying the regulation mechanism of blood lipids.ObjectiveTo analyze the effects of TSH and testosterone on blood lipids in patients with IHH by comparing the differences in blood lipids between different TSH levels in male patients with IHH.Methods119 male patients with IHH who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2014 to February 2019?including 75 nIHH and44 KS?were selected.They were divided into two groups:group A?TSH?2.57 mIU/mL?in 75 cases,group B?TSH>2.57 mIU/mL?in 44 cases.Sex hormones?thyroid hormones and blood lipids were compared between the two groups.using correlation analysis to explore the correlation between TSH and blood lipids.Results?1?Compareed with TSH low-value group in male patients with IHH,TC and LDL-C were higher in the TSH high-value group,and the difference was statistically significant?P<0.05?.?2?simple correlation analysis of age,BMI,FT3,FT4,TSH,T,Hb,FBG and24hUFC of male patients with IHH and TC,TG,HDL-C and LDL-C in blood lipids showed that there was a positive correlation between age,FT3,TSH and Hb and TC?P<0.05?.There was a positive correlation between BMI and TG?P<0.001?.There was a negative correlation between BMI and HDL-C?P<0.001?.Age,BMI,FT₃,TSH and Hb were positively correlated with LDL-C?P<0.05?.?3?Partial correlation analysis was performed in male patients with IHH.The results showed that TSH was positively correlated with TC and LDL-C after adjusting for age,BMI,T and Hb?P<0.05?.After adjusting for age,BMI,FT3,FT4,T and Hb,TSH was still positively correlated with TC and LDL-C?P<0.05?.?4?Multiple linear regression analysis in male patients with IHH showed that there was a linear positive correlation between TSH and TC,also between TG and LDL-C.The regression coefficients were 0.284?P<0.01??0.187?P<0.05?and 0.253?P<0.01?,respectively.?5?Factorial analysis in male patients with IHH showed that there was an interaction between TSH and testosterone on TC?P<0.05?.ConclusionsWithin the reference range of normal TSH,elevated serum TSH level in male patients with IHH may cause increased serum TC and LDL-C levels.