2型糖尿病患者血清甲状腺激素水平变化的临床意义

Clinical significance of serum thyroid hormones in patients with type 2 diabetes

目的观察2型糖尿病患者血清甲状腺激素水平的改变。方法将168例2型糖尿病患者按糖化血红蛋白(GHbA1c)高低分四组:<6.5%组,6.5%-7.5%组,7.6%-10.0%组,>10.0%组;按是否有血管并发症分为:无并发症组,伴大血管并发症组,伴微血管并发症组及伴大、微血管并发症组。检测甲状腺激素水平。结果与正常对照组比较,2型糖尿病组TT3、FT3明显下降(P<0.01);与GHbA1c<6.5%组比较,6.5%-7.5%组(P<0.05)、7.6%-10.0%组(P<0.01)、>10.0%组TT3、FT3均明显下降(P<0.01)。与无并发症组比较,伴大血管组、微血管组及伴大微血管组TT3、FT3均明显下降(P<0.01)。结论 2型糖尿病患者病情越重,甲状腺激素水平下降幅度越大。

Objective To observe the thyroid hormones in patients with type 2 diabetes.Methods One hundred and sixty-eight patients with type 2 diabetes were divided into four groups according to their glycosylated hemoglobin（GHbA1c） level（6.5%,6.5%-7.5%,7.6%-10.0%,10.0%）.The patients were further divided into no complication group,major vascular complication group,microvascular complication group,and major and microvascular complication group.Thyroid hormone levels were measured in all patients.Results The level of TT3 and FT3 was lower in patients with type 2 diabetes than in control group（P0.01）.The level of TT3 and FT3 was higher in 6.5%-7.5% and 7.6%-10.0% GHbA1c groups,and lower in 10.0% GHbA1c group than in GHbA1c6.5% group（P0.01）.The level of TT3 and FT3 was significantly lower in patients with complications than in those without complications.Conclusion The severer the type 2 diabetes is,the lower the thyroid hormone level is.