老年2型糖尿病患者合并甲状腺疾病的436例回顾性分析

A retrospective analysis of 436 elderly patients with type 2 diabetic mellitus combined with thyroid dysfunction

目的调查老年2型糖尿病患者合并甲状腺疾病的患病情况。方法回顾分析2007年1月~2010年12月在我院就诊的老年2型糖尿病（T2DM）患者436例（老年T2DM组）,以及同期体检的老年健康人群372例（对照组）的甲状腺功能状况,并对436例老年T2DM组患者进行甲状腺超声检查。结果老年T2DM组甲状腺疾病总患病率为31.65%,其中,甲状腺功能减退者占22.70%（甲减患者占9.63%,亚甲减患者占13.07%）,明显高于甲状腺功能亢进患者的8.94%（甲亢患者占4.12%,亚甲亢患者占4.81%）,差异有统计学意义（P〈0.05）;女性患甲状腺疾病的风险显著高于男性（P〈0.05）;甲状腺过氧化物酶抗体（TPOAb）阳性（＋）者186例（42.66%）,抗甲状腺球蛋白抗体（TgAb）阳性（＋）者158例（36.23%）,女性TPOAb（＋）和TgAb（＋）率均高于男性（P〈0.01）;老年T2DM组甲状腺结节的发病率高达74.08%,单发结节与多发结节的发病率相当（48.91%vs 51.08%,P〉0.05）,男女性别间结节的检出率差异无统计学意义（P〉0.05）。结论老年T2DM患者具有较高的甲状腺疾病患病率,可能影响糖尿病的病情和预后,筛查以及定期随访老年T2DM患者的甲状腺功能。

Objective To investigate the prevalence of thyroid dysfunction in elderly type 2 diabetic mellitus（T2DM） patients.Methods 436 cases of T2DM elderly patients who were treated in our hospital from January 2007 to December 2010 were divided into T2DM elderly group,and 372 cases of healthy elderly people who took physical examination in our hospital in the same period were divided into control group,the thyroid function was checked.Thyroid ultrasound scan was given to the T2DM group.Results The prevalence of thyroid dysfunction in T2DM group was 31.65%,of which prevalence of hypothyroidism accounted for 22.70%（9.63% of hypothyroidism,13.07% of subclinical hypothyroidism） was significantly higher than the prevalence of hyperthyroidism,which accounted for 8.94%（4.12% of hyperthyroidism,4.81% of subclinical hyperthyroidism）.The risk of female suffered from thyroid disease were significantly higher than that of male（P 〈 0.05）.186 cases（42.66%） were TPOAb positive,158 cases（36.23%） were TgAb positive,female had higher rates of TPOAb（＋） and TgAb（＋） than male（P 〈 0.01）.The incidence of thyroid nodules of elderly T2DM group was 74.08%,the incidence rate between single nodules and multiple nodules had no significantly difference（48.9% vs 51.08%,P 〉 0.05）.The detection rate of nodules had no significant difference between male and female（P 〉 0.05）.Conclusion Elderly patients with T2DM have higher incidence of thyroid disease,which may affect the diabetes and prognosis.Screening and regular following-up the thyroid function,thyroid antibodies and thyroid morphology of elderly patients with T2DM have important clinical significance