2型糖尿病患者血胆红素与糖脂代谢及甲状腺功能的相关性

Correlation of bilirubin with glucose and lipid metabolism and thyroid function in type 2 diabetic patients

目的探讨2型糖尿病(T2DM)血胆红素与糖脂代谢及甲状腺功能的相关性。方法回顾性分析2022-01至2023-08武警特色医学中心收治的T2DM患者170例(T2DM组)的临床资料,另选取89例健康体检者为对照组(NC组)。T2DM组根据HbA1c控制情况分为血糖控制良好亚组(H1)、血糖控制欠佳亚组(H2)及血糖控制差亚组(H3)。根据血脂水平分为血脂正常亚组(L1)及血脂异常亚组(L2)。比较各组间生化指标差异,并分析各指标与胆红素的相关性。结果T2DM组血清总胆红素(TBil)、直接胆红素(DBil)、促甲状腺激素(TSH)、游离T_(3)(FT_(3))显著降低(P<0.05)。H3亚组FT_(3)低于H1亚组(P<0.05),H2和H3亚组游离T_(4)(FT_(4))高于H1亚组(P<0.05)。L2亚组TBil、DBil显著低于L1亚组(P<0.05)。Pearson相关分析显示,TBil、DBil均与TSH呈负相关(P<0.05),DBil还与TC、TG、LDL-C呈负相关(P<0.05)。多元逐步回归分析显示,TSH、TC、LDL-C、HbA1c分别是TBil和DBil的影响因素。结论T2DM患者血胆红素与糖脂代谢及甲状腺功能指标显著相关。

Objective To investigate the correlation between bilirubin and glucose and lipid metabolism and thyroid function in patients with type 2 diabetes mellitus(T2DM).Methods A total of 170 patients with type 2 diabetes mellitus admitted to Characteristics Medical Center of Chinese People's Armed Police Force and another 89 healthy people were selected.Based on HbA1c control,T2DM patients were divided into subgroups with good blood glucose control(H1),poor glucose control(H2)and very poor glucose control(H3).According to the level of blood lipid,T2DM patients were divided into subgroups with normal blood lipids(L1)and high blood lipids(L2).The difference of biochemical indices among all groups was compared,and the correlation between each index and bilirubin was analyzed.Results Compared with NC group,TBil,DBil,TSH and FT_(3)decreased in T2DM group(P<0.05).The level of FT_(3)in H3 subgroup was lower than that in H1 subgroup(P<0.05),and the level of FT4 in H2 and H3 subgroup were higher than that in H1 subgroup(P<0.05).The TBil and DBil of L2 subgroup were significantly lower than those of L1 subgroup(P<0.05).TSH was negatively correlated with TBil and DBil(P<0.05),and DBil was also negatively correlated with TC,TG and LDL-C(P<0.05).Multiple stepwise regression analysis showed that TSH,TC,LDL-C and HbA1c were influencing factors for TBil and DBil.Conclusions Bilirubin is closely related with glucose and lipid metabolism and thyroid function in T2DM patients.