The Change Of Serum Adiponectin Before And After Antithyroid Drug Therapy In Graves’ Hyperthyroid Patients

ABSTRACTObjective:Adiponectin(APN) which is specifically secreted by mature adipose cells is a cellular factor, and its clinical effect is gradually being studied. There are a series of hormonal and biochemical changes before and after therapy in patients with Graves’ disease.Nowadays,the researches about changes of serum adiponectin in patients with hyperthyroidism before and after antithyroid drug therapy are a little less,moreover,the conclusions are also controversial.In this study,we will investigate the changes of serum adiponectin and some related factors,such as glycometabolism,lipid metabolism,thyroid hormones and insulin resistance index,before and after antithyroid drug therapy.And the aim is to judge the change characteristic of adiponectin levels in hyperthyroidism patients and its relationship with glycometabolism and lipid metabolism.Methods:We choose three groups of sample to study, the normal control(NC) group with 6 male cases and 12 female cases was selected from the Medical Examination Center in the Second Hospital of Hebei Medical University during September and December in 2014.They have no thyroid disease or a history of other diseases. And their fasting blood glucose, postprandial 2 hour’s blood glucose values, thyroid antibodie,thyroid function,blood fat and thyroid ultrasonography are within the normal range.The GD1 group with 11 male cases and 24 female cases was chosen from patients who are newly diagnosed Graves’ disease by the Endocrinology Department in the Second Hospital of Hebei Medical University during June 2014 and January 2015.All the subjects do not have malignant tumor history, blood system disease or other autoimmune system disease,and they are not associated with chronic hypertension,coronary heart disease,cerebrovascular disease,the history of diabetes or other chronic medical history.Both their liver and kidney are healthy,and without acute and chronic infection.The samples of GD2 group were the specimens of GD1 group when the FT3 and FT4 of GD1 group go back to normal for the first time after antithyroid drug therapy.In our study,all the subjects’ weight,height and other data were recorded, and the percentage of body fat(BF%) was calculated as follows,BF%=(1.20×BMI)+(0.23×age)-(10.8×sex)-5.4,1 for male and 0 for female.For all the subjects,we collected their biochemical indexes, fasting blood glucose,thyroid function and FINS from their fasting venous blood.As for the GD1 group,we collected the Thyrotropin Receptor Antibody(TRAb) in addition,and 2ml venous blood was preserved and used to separate the serum with 20 minutes’ offcenter under 2500r/min.After the serum was separated,they were preserved in a refrigerator with-70℃ situation.Finally,serum adiponectin was measured by using double antibodies sandwich ELISA.In our study,SPSS 13.0 data statistical software was used to deal with all the data.We first tested the data’s normality,and for the data which conformed to the normal distribution,we gave them as Mean±SD.Paired-samples t-test was adopted between GD1 and GD2 groups,and other two groups were compared using two-samples t-test.As for the non-normal data,the Median/Interquartile Range representation was adopted,comparisons between groups using Nonparametric test.Correlation of two indexes was assayed using Spearman correlation coefficients.Multiple variables regression analysis was assayed using multiple stepwise regression analysis.All the tests were two-sided,and a value of P<0.05 was considered as statistically significant.Result:1 Comparisons among age,sex and height,there was no significant difference among the three groups(P>0.05).The levels of weight,body fat percentage in GD1 group were significantly lower than that in GD2 group(P<0.05).The levels of weight,body fat percentage had no significant difference between GD1 and NC groups or GD2 and NC groups(P>0.05).2 Comparisons of the thyroid function among the three groups,the levels of FT3,FT4 in GD1 group were significantly higher than NC and GD2 groups(P<0.05).In GD2 group,the levels of FT3 was higher than NC group(P<0.05). In GD2 group,the level of FT4 was a little lower than NC group,but there was no significant difference between them(P>0.05).3 Adiponectin comparisons among the three groups:the levels of serum adiponectin in GD1 group was significantly higher than NC and GD2 group(P<0.05).And in GD2 group,the levels of adiponectin was lower than NC group(P<0.05).4 Biochemical criterion and HOMA-IR comparisons between GD1 and NC group.The levels of fasting blood glucose,FINS,HOMA-IR in GD1 group were significantly higher than NC group(P<0.05).The levels of CHOL,HDL,LDL in GD1 group were significantly lower than NC group(P<0.05).As for TG,there was no significant difference between GD1 and NC group.5 By spearman correlation tests of NC,GD1 and GD2 groups,the level of serum adiponectin was positively correlated with FT3,FT4.While TSH showed a negative correlation.There was no significant correlation with the age, height,weight,body fat percentage and BMI.In GD1 group,correlation analysis showed the level of serum adiponectin was positively correlated with FT4.6 By Multiple Stepwise Regression(adiponectin as dependent variable, body fat percentage,TSH,FT3,FT4,age,height,weight and BMI as the independent variable),in NC,GD1 and GD2 groups,the level of serum adiponectin was greatly influenced by FT4,F=38.295,P<0.001.When the GD1 group was solely applied to analyze,it showed that adiponectin level was greatly influenced by FT4 and CHOL,F=8.083,P<0.01.Conclusion:1 This study reveals that the level of serum adiponectin in Graves’ disease before treatment is higher than normal,and it declines after antithyroid drug therapy.2 This study reveals that the level of serum adiponectin in Graves’ disease is greatly influenced by FT4 and CHOL,and there was no significant correlation with glycometabolism.3 This study also reveals that compared with the normal control group,the level of serum adiponectin in Graves’ disease group after treatment is lower.It may be associated with that when we take samples the level of FT4 in GD2 group is a little lower than NC group.