2型糖尿病患者糖脂代谢与血清甲状腺激素相关性分析

Correlation of serum thyroid hormones with glucose and lipid metabolism in type 2 diabetes patients

目的探讨甲状腺功能正常的T2DM患者血清甲状腺激素与血糖、血脂等的关系。方法 291例T2DM患者,测定FPG、HbA1c、血脂、UA及甲状腺激素。结果按HbA1c水平分为三组,不同组间的促甲状腺素(TSH)之间差异有统计学意义(P<0.01),HbA1c≥11%组的游离三碘甲状腺原氨酸(FT3)显著低于另两组(P<0.05);按不同TSH水平分为三组,不同组间的TC及TG之间差异有统计学意义(P<0.01);与0.5～1.5mU/L组相比,2.5～5.0mU/L组的LDL-C、UA显著升高(P<0.05);TSH与HbA1c呈负相关性(r=-0.123,P<0.05),与TG、TC、LDL-C、UA呈正相关性(r=0.186、0.134、0.121、0.148,P<0.05),三碘甲腺原氨酸(TT3)与TC、LDL-C呈正相关性(r=0.170、0.178,P<0.01),与UA呈负相关性(r=-0.117,P<0.05),FT3与HbA1c、FPG、年龄呈负相关性(r=-0.15、-0.120、-0.226,P<0.05)。年龄、FPG是影响FT3变化的独立因素(OR=-0.192、0.272,P<0.01)。结论甲状腺激素水平对评估T2DM患者糖、脂及嘌呤代谢有重要意义。

Objective To investigate the correlation of serum thyriod hormone with plasma glucose and blood lipid in T2DM patients with normal thyroid functions. Methods A total 291 patients were enrolled in this study. Their fasting plasma glucose（FPG）, hemoglobin Alc（HbA1 c）, blood lipids, uric acid（UA）, and thyroid hormone were examined. Results Patients were divided into three groups according to their levels of HbAlc. Thyrotrophin（TSH） levels were significantly different between 3 groups（P（0.01）. The free triiodothyronine（FT3） level was significantly lower in the HbAlc≥ll% group than in other groups（P（0. 05）. According to the TSH level, they were also divided into three groups. The total cholesterol（TC） and triglyceride（TG） levels were significantly different between 3 groups（P〈0.01）. The low density lipoprotein cholesterol（LDL-c） and UA levels in the 0.5-1.5 mU/L group was significantly higher than in the 2. 5 - 5. 0 mU/L group （P（0. 05）. TSH was correlated negatively with HbAlc（r=-0. 123, P（0.05） and positively with TG, TC, LDL-C, and UA（r=0. 186, 0. 134, 0. 121, 0. 148, P〈0. 05）. Total triiodothyronine（TT3） was correlated positively with TC and LDL-C（r=0. 170, 0. 178, P〈0. 01） and negatively with UA（r=--0. 117, P〈0. 05）. FT3 was negatively correlated with HbAlc, FPG, and age（r= -0.15,-0. 120,-0. 226, P〈0. 05）. Age and FPG were the independent factors influencing the changes of FT3 （OR = --0. 192, 0. 272, P〈0. 01）. Conclusion The level of thyroid hormone is of great clinical significance for assessment of the glucose, lipid, and purine metabolism in diabetic patients.