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고콜레스테롤혈증 성인환자에서 무증상 갑상선 기능저하증의 빈도와 혈청 콜레스테롤 치에 대한 혈청 TSH 의 영향
정원제(Won Jea Jeong),박병헌(Byeong Heon Park),박철영(Cheol Young Park),류미숙(Mee Sook Ryu),오승준(Seung Joon Oh),우정택(Jeong Tack Woo),김성운(Sung Woon Kim),양인명(In Myoung Yang),김진우(Jin Woo Kim),최영길(Young Kil Choi),팽정령( 대한내과학회 2002 대한내과학회지 Vol.62 No.2
N/A Background: Subclinical hypothyroidism is frequently discovered from hypercholesterolemic adults. It is defined as an asymptomatic state which characterized by normal free thyroxine (FT4) and elevated thyroid stimulating hormone (TSH) level. Hypercholesterolemia is a major risk factor for coronary heart disease, however hypercholesterolemia caused by hypothyroidism can be easily managed by thyroid hormone replacement. The screening of thyroid disease in hypercholesterolemia patient must be emphasized in order to find out correctable hypothyroidism. So we screened the prevalence of overt and subclinical hypothyroidism at different hypercholesterol levels in middle-aged men and women and also analyzed the correlation between TSH and total cholesterol level. Methods: We measured serum TSH levels and FT4 by radioimmunoassay from 491 patients with hypercholesterolemia. The subjects were divided into two groups according to serum cholesterol level. Group I was serum cholesterol ≥240 -〈300 mg/dL and group II was ≥300 mg/dL. Subclinical hypothyroidism was defined as TSH levels higher than 4 mU/L, in the presence of normal FT4 concentration. Results: The overall prevalence of subclinical and overt hypothyroidism was 3.4% and 2.5% in men and 4.7% and 3.5% in women of middle age. In men the prevalence of overt and subclinical hypothyroidism increased from 2.3% of group I to 16.1% in the group II (p<0.05). In women that increased from 5.2 % to 12.9 % (p<0.05). After age correction, an increase of 1 mU/L TSH in men was associated with an increase of 3.2 mg/dL total cholesterol (p<0.01). A similar trend was also found in women (2.1 mg/dL p=0.052). Conclusion: In this population, the prevalence of hypothyroidism is up to 16.1% in middle-aged men, 12.9% in middle-aged women with high total cholesterol and it may justify screening of thyroid disease in hypercholesterolemic patients especially in clinical practice.(Korean J Med 62:187-193, 2002)