新诊断糖尿病患者甲状腺功能异常的筛查

The screening of thyroid dysfunction in newly diagnosed diabetes mellitus

目的探讨新诊断DM患者血清甲状腺激素水平及甲状腺抗体的变化及临床意义。方法用放射免疫法测定血清甲状腺激素水平及甲状腺抗体。结果新诊断DM患者中,甲状腺功能异常发生率15.5%;女性发病率高于男性3:1。在这些甲功异常患者中,T2DM 87例,T1DM 9例;甲亢患者占78.2%(临床甲亢32.3%,亚临床甲亢45.9%),甲减21.9%(临床甲减6.3%,亚临床甲减15.6%),甲亢发生率高于甲减,亚临床甲亢发生率显著高于亚临床甲减(45.9%:15.6%,P<0.05)。T1DM甲状腺抗体阳性率达100%,T2DM TPOAb、TGAb阳性率分别为39.2%、43.3%。结论新诊断DM可并存甲状腺功能亢进和减退,主要为甲亢。

Objective To investigate the variety and clinical significances of serum thyroid hormones and thyroid autoantibody in newly diagnosed diabetes patients. Methods Using RIA to measure serum thyroid hormones and thyroid antibody. Results In newly diagnosed diabetes patients, the incidence of thyroid dysfunction was 15. 5%, the female to male ratio is 3： 1. In these patients with thyroid dysfunction, 87 had T2DM, 9 had TIDM. The percentage of hyperthyroidism patients was 78. 2% （the clinical hyperthyroidism was 32. 3 %, the subclinical hyperthyroidism was 45. 9 %）, and the percentage of hypothyroidism patients was 21.9%（the clinical hypothyroidism was 6. 3 %, the subclinical hypothyroidism was 15. 6 %, P〈0. 05）. The positive rate of TPOAb in T1DM was 100%, and the positive rates of TPOAb and TGAb in T2DM were 45. 9% and 43. 3%, respectively. Conclusion Newly diagnosed diabetes often combined with hyperthyroidism and hypothyroidism, especially hyperthyroidism.