Abstract
BackgroundZinc-α2-glycoprotein (ZAG) is a recently novel lipolytic adipokine implicated in regulation of glucose and lipid metabolism in many metabolic disorders. In vitro and animal studies suggest that thyroid hormones (TH) up-regulates ZAG production in hepatocytes. However, there is no data evaluating the possible relationship between ZAG and TH in a human model of hyperthyroidism. The objective of the present study is to assess the association of serum ZAG levels with TH and lipid profile in patients with hyperthyroidism before and after methimazole treatment.MethodsA total of 120 newly diagnosed overt hyperthyroidism and 122 healthy control subjects were recruited. Of them, 39 hyperthyroidism patients were assigned to receive methimazole treatment as follow-up study for 2 months.ResultsThe clinical consequence showed that serum ZAG levels were elevated in patients with hyperthyroidism (P < 0.01). Adjust for age, gender and BMI, serum ZAG levels were positively related with serum free T3 (FT3), free T4 (FT4) levels and negatively correlated with serum total cholesterol (TC), low density lipoprotein cholesterol (LDLC) levels in hyperthyroidism subjects (all P < 0.01). After methimazole treatment, serum ZAG levels were decreased and the decline was associated with decreased FT3, FT4 and increased TC levels (all P < 0.001).ConclusionWe conclude that ZAG may be involved in the pathogenesis of lipid metabolism disorder in patients with hyperthyroidism.Trial registrationChiCTR-ROC-17012943. Registered 11 October 2017, retrospectively registered.
Highlights
Hyperthyroidism is a clinical situation where there is excess thyroid hormones (TH) in the circulation due to increased synthesis of hormone from a hyperactive thyroid gland [1]
In addition to typical clinical symptoms like resting energy expenditure and weight loss directly related to excess TH, the patients with hyperthyroidism are likely to accompanied by changes in lipid metabolism [2, 3]
Numerous putative underlying mechanisms have been proposed to explain this changes in lipid metabolism: i) TH can directly trigger a series of pathway mainly involved in lipid metabolism and energy homeostasis, such as PI3K/ Akt, MAPK/ERK, SIRT1, peroxisome proliferator activated receptors (PPARs), etc. [21, 22]. ii) More importantly, TH participates in the regulation of adipocyte functions including secreting adipokines [10, 23, 24]
Summary
Hyperthyroidism is a clinical situation where there is excess TH in the circulation due to increased synthesis of hormone from a hyperactive thyroid gland [1]. In addition to typical clinical symptoms like resting energy expenditure and weight loss directly related to excess TH, the patients with hyperthyroidism are likely to accompanied by changes in lipid metabolism [2, 3]. Several lines of evidence have shown that adipokines, such as adiponectin, leptin, resistin and fibroblast growth factor 21, etc., play an important role in regulating energy expenditure and metabolism of lipids [5,6,7,8]. Researchers demonstrate that apart from abnormal circulating levels of TH and thyroid-stimulating hormone (TSH), changes in profile of adipokines (like adiponectin, leptin and resistin, etc.) have been found in patients with hyperthyroidism [9,10,11]. The objective of the present study is to assess the association of serum ZAG levels with TH and lipid profile in patients with hyperthyroidism before and after methimazole treatment
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