Objective: To investigate the changes of thyroid function and blood lipids in patients with Graves' hyperthyroidism after 131I treatment.Methods: Serum thyroid stimulating hormone(TSH), free triiodothyronine(FT3), free thyroxine(FT4), triglyceride(TG), cholesterol(TC), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C),apolipoprotein A(APOA), apolipoprotein B(APOB), glucose(Glu), blood urea nitrogen(BUN),creatinine(Cr)were measured before and 3 months after treatment. According to the thyroid hormone level 3 months after 131I treatment, the patients were divided into hypothyroid group(64cases), euthyroid group(27cases), hyperthyroidism improved group(21cases)and hyperthyroidism rebounded group(15cases). 64 cases with hypothyroidism were further divided into four groups,0-1 group,3-1 group,6-1 group and 9-1 group, and the proportion of dyslipidemia in each group was compared. Results: After 131I treatment, FT3 and FT4 were significantly decreased in the hypothyroid, euthyroid and hyperthyroidism improved groups(P<0.01), while TSH, TC, HDL-C, LDL-C, APOA, APOB, and Cr were increased(P<0.05). In the hyperthyroidism rebounded group, FT3 and FT4 increased, Cr decreased after treatment(P<0.05), there was no significant change in blood lipids. Glu and BUN decreased in the hypothyroid and euthyroid groups after treatment(P<0.05).When FT4≤6 pmol·L-1, the proportion of hypercholesterolemia increased significantly. Conclusion: Significant improvements in FT3, FT4, Glu, BUN and Cr are observed after 131I treatment,and blood lipids increases with the decrease of FT3, FT4, especially in hypothyroid group, when FT4≤6 pmol·L-1, should be on guard against hyperlipidaemia.
 IMAM SUBEKTI1 L A P.Current diagnosis and management of Graves' disease[J].Acta Med Indones-Indones J Intern Med,2018,50(2):177-182.
 ROSS D S,BURCH H B,COOPER D S,et al.2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis[J].Thyroid,2016,26(10):1343-1421.
 BIONDI B,COOPER D S.Thyroid hormone therapy for hypothyroidism[J].Endocrine,2019,66(1):18-26.
 BANSAL S K,YADAV R.A study of the extended lipid profile including oxidized LDL,small dense LDL,lipoprotein(a) and apolipoproteins in the assessment of cardiovascular risk in hypothyroid patients[J].J Clin Diagn Res,2016,10(6):BC04-08.
 ZHANG X,SONG Y,FENG M,et al.Thyroid-stimulating hormone decreases HMG-CoA reductase phosphorylation via AMP-activated protein kinase in the liver[J].J Lipid Res,2015,56(5):963-971.
 CHOI J W,CHOI H S.The regulatory effects of thyroid hormone on the activity of 3-hydroxy-3-methylglutaryl coenzyme A reductase[J].Endocr Res,2000,26(1):1-21.
 PEARCE E N.Hypothyroidism and dyslipidemia:modern concepts and approaches[J].Curr Cardiol Rep,2004,6(6):451-456.
 KOTWAL A,CORTES T,GENERE N,et al.Treatment of Thyroid dysfunction and serum lipids:a systematic review and meta-analysis[J].J Clin Endocrinol Metab,2020,105(12):3683-3694.
 DONG B,SINGH A B,FUNG C,et al.CETP inhibitors downregulate hepatic LDL receptor and PCSK9 expression in vitro and in vivo through a SREBP2 dependent mechanism[J].Atherosclerosis,2014,235(2):449-462.
 RONSEIN G E,VAISAR T.Inflammation,remodeling,and other factors affecting HDL cholesterol efflux[J].Curr Opin Lipidol,2017,28(1):52-59.
 VAN DER BOOM T,JIA C,LEFRANDT J D,et al.HDL cholesterol efflux capacity is impaired in severe short-term hypothyroidism despite increased HDL cholesterol[J].J Clin Endocrinol Metab,2020,105(9):3355-3362
 WALLDIUS G,JUNGNER I,HOLME I,et al.High apolipoprotein B,low apolipoprotein A-I,and improvement in the prediction of fatal myocardial infarction(AMORIS study):a prospective study[J].Lancet,2001,358(9298):2026-2033.
 GRUNDY S M,STONE N J,BAILEY A L,et al.2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol:Executive Summary:A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines[J].Circulation,2019,139(25):e1046-e1081.
 MONZANI F,CARACCIO N,KOZAKOWA M,et al.Effect of levothyroxine replacement on lipid profile and intima-media thickness in subclinical hypothyroidism:a double-blind,placebo-controlled study[J].J Clin Endocrinol Metab,2004,89(5):2099-2106.
 YAN Y,NIU Z,SUN C,et al.Hepatic thyroid hormone signalling modulates glucose homeostasis through the regulation of GLP-1 production via bile acid-mediated FXR antagonism[J].Nat Commun,2022,13(1):6408.
 IGLESIAS P,DIEZ J J.Thyroid dysfunction and kidney disease[J].Eur J Endocrinol,2009,160(4):503-515.
 MARIANI L H,BERNS J S.The renal manifestations of thyroid disease[J].J Am Soc Nephrol,2012,23(1):22-26.
 IGLESIAS P,BAJO M A,SELGAS R,et al.Thyroid dysfunction and kidney disease:An update[J].Rev Endocr Metab Disord,2017,18(1):131-144.
 SONMEZ E,BULUR O,ERTUGRUL D T,et al.Hyperthyroidism influences renal function[J].Endocrine,2019,65(1):144-148.
 ASVOLD B O,BJORO T,VATTEN L J.Association of thyroid function with estimated glomerular filtration rate in a population-based study:the HUNT study[J].Eur J Endocrinol,2011,164(1):101-105.
 JOO E Y,KIM Y J,GO Y,et al.Relationship between perioperative thyroid function and acute kidney injury after thyroidectomy[J].Sci Rep,2018,8(1):13539.
 KREISMAN S H,HENNESSEY J V.Consistent reversible elevations of serum creatinine levels in severe hypothyroidism[J].Arch Intern Med,1999,159(1):79-82.
 SYME H M.Cardiovascular and renal manifestations of hyperthyroidism[J].Vet Clin North Am Small Anim Pract,2007,37(4):723-743.
 TENORIO-VELAZQUEZ V M,BARRERA D,FRANCO M,et al.Hypothyroidism attenuates protein tyrosine nitration,oxidative stress and renal damage induced by ischemia and reperfusion:effect unrelated to antioxidant enzymes activities[J].BMC Nephrol,2005,6:12.