Study On The Correlation Between Serum TSH Level And Blood Lipid In Patients With Shorter Stature

Objective: To explore the association with the thyroid-stimulating hormone(TSH)and lipid profiles [triglyceride(TG),total cholesterol(TC),low density lipoprotein-cholesterol(LDL-C),high density lipoprotein-cholesterol(HDL-C)] and to evaluate the interaction of TSH and height on blood lipids in children with shorter stature.Methods: 1610 Subjects of the study were included in the study,who came from the Growth and Development Diseases in Shandong Province: a cohort follow-up study(GDDSD study)and were diagnosed as shorter stature in the Endocrinology Department of the Affiliated Hospital of Jining Medical University from March 2013 to February 2019.The survey collected basic information including Patient's basic information,patient's birth situation,maternal pregnancy,past medical history,etc.;physical examination data including height(Ht),weight(Wt),blood pressure(BP)and heart rates,etc.;laboratory examination including blood routine,electrolytes,lipid profiles,thyroid function,liver function,kidney function,insulin-like growth factor-1(IGF-1);left hand and wrist joint radiographs,pituitary magnetic resonance,gynecological ultrasound(female patients)etc.were mainly included in imaging examination items.The study population was divided into three groups: Tertile 1,Tertile 2,and Tertile 3 according to the TSH level.The differences in clinical indicators of patients were compared among the three groups.To investigate the correlation between serum TSH and blood lipids,the univariate analysis and multiple regression analysis were used and the effects of height and TSH on blood lipids were assessed by using interactions.Results:(1)Among the patients with shorter stature,the LDL-C and TC/HDL-C levels in the Tertile 3 were higher than those in the Tertile 2 and Tertile 1 with the increasing TSH level(P < 0.05).(2)Univariate analysis of blood lipids and clinical indicators in shorter stature showed that age,BMI SDS were positively correlated with TG and FT4 was negatively correlated with TG(P <0.05);age,BMI SDS,and AST were positively correlated TC,however,height SDS,IGF-1 SDS,puberty stages were negatively correlated with TC(P <0.05);Age,Height SDS,BMI SDS,IGF-1 SDS,puberty stage were negatively correlated with HDL-C(P <0.05);IGF-1 SDS and puberty stage were negatively correlated with LDL-C,and age,BMI SDS,AST,TSH were positively correlated with LDL-C(P <0.05).(3)The smooth curve fitting showed that TSH had a non-linear relationship with TG,LDL,and TG/HDL-C in the patients with shorter stature.When TSH was greater than 4.5mIU/L,TG,LDL-C and TG/HDL-C were positively correlated with the elevation of the TSH value,respectively(?=0.05,95%CI:0.01-0.10,P=0.024;?=0.12,95%CI:0.04-0.20,P=0.003;?=0.07,95%CI:0.02-0.12,P=0.009).(4)The interaction between height and TSH on blood lipids was evaluated by the interaction test in patients with shorter stature.As a result,no significant interaction between Height SDS and TSH on blood lipids was found(P > 0.05).Conclusions: A non-linear relationship was founded in the study between serum TSH levels with TG,LDL-C,and TG to HDL-C ratio among shorter stature.The serum TSH level positively correlated with serum TG,LDL-C and TG/HDL-C when TSH increased to a certain degree.We need to pay more attention to assessing the risk of cardiovascular disease when children with shorter stature accompanied by elevated TSH levels in future study.