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中华肥胖与代谢病电子杂志 ›› 2025, Vol. 11 ›› Issue (02) : 129 -134. doi: 10.3877/cma.j.issn.2095-9605.2025.02.007

综述

肥胖与甲状腺疾病研究进展
柏兰1, 王文斌1, 夏泽锋2,(), 刘洋2   
  1. 1430014 武汉,江汉大学附属医院·武汉市第六医院甲状腺乳腺外科
    2430022 武汉,华中科技大学附属协和医院胃肠外科
  • 收稿日期:2024-03-10 出版日期:2025-05-30
  • 通信作者: 夏泽锋
  • 基金资助:
    江汉大学附属医院科研项目(K20230328007)

Obesity and thyroid disease: An update

Lan Bai1, Wenbin Wang1, Zefeng Xia2,(), Yang Liu2   

  1. 1Department of Thyroid and Breast Surgery, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University, Wuhan 430014, China
    2Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
  • Received:2024-03-10 Published:2025-05-30
  • Corresponding author: Zefeng Xia
引用本文:

柏兰, 王文斌, 夏泽锋, 刘洋. 肥胖与甲状腺疾病研究进展[J/OL]. 中华肥胖与代谢病电子杂志, 2025, 11(02): 129-134.

Lan Bai, Wenbin Wang, Zefeng Xia, Yang Liu. Obesity and thyroid disease: An update[J/OL]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2025, 11(02): 129-134.

肥胖与甲状腺疾病密切相关。肥胖可能通过炎症反应、胰岛素抵抗和激素失衡等机制影响甲状腺功能;同时肥胖也增加个体患甲状腺癌的风险。此外,甲状腺疾病也可能导致体重增加和代谢紊乱。现有研究尚未证明肥胖合并甲状腺疾病患者是否需要与正常体重患者不同的治疗策略。本文总结肥胖和甲状腺疾病的相互关系,探讨其可能机制,为临床实践提供参考。

Obesity is closely related to thyroid disease. Obesity may affect thyroid function through inflammatory response, insulin resistance and hormone imbalance. Obesity also increases an individual's risk of thyroid cancer. In addition, thyroid disease may also lead to weight gain and metabolic disorders. Evidence from available studies cannot demonstrate whether obese patients with thyroid disease require different treatment strategies than normal-weight patients. This paper summarizes the relationship between obesity and thyroid disease and discussed its possible mechanism to provide a reference for clinical practice.

图1 肥胖与甲状腺激素水平变化的部分机制注:①高瘦素血症刺激TRH和TSH的合成和分泌、影响皮下脂肪组织中的脱碘酶D1的活性。②脱碘酶、TRa受体以及TSHR的表达和活性的改变促甲状腺激素的抵抗状态。③炎性脂肪因子损害甲状腺功能,导致腺体形态改变。这些脂肪因子也可能改变脱碘酶的活性。④胰岛素抵抗有助于甲状腺细胞脱碘酶D2活性,引起甲状腺功能减退和TSH合成增加。⑤血清TSH、T3和T4的变化,导致能量消耗增加,影响身体组织的代谢调节。 TRH为促甲状腺激素释放激素;TSH为促甲状腺激素;TNF-α为肿瘤坏死因子-α;IL-6为白细胞介素-6;T3为三碘甲状腺原氨酸;T4为四碘甲状腺原氨酸;TRa甲状腺受体抗体;TSHR为促甲状腺激素受体
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