2型糖尿病患者甲状腺功能状态的研究

Thyroid Function in Patients with Type 2 Diabetes

目的通过与健康体检者比较,了解2型糖尿病(2-DM)患者的甲状腺功能状态。方法检测120例住院2-DM患者(研究组)及同期60例健康体检者(对照组)游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)水平;研究组同时加测血脂、血糖、糖化血红蛋白(GHb)、血肌酐。结果研究组甲状腺功能正常103例(a组)。17例甲状腺功能异常中甲状腺功能低下(均为亚临床甲状腺功能减退,简称亚甲减)15例(b组)占12.5%,女性多于男性(18.3%比6.7%,P<0.05);甲状腺功能亢进(均为亚临床甲状腺功能亢进,简称亚甲亢)2例(c组)占1.7%。对照组中2例(占3.3%)甲状腺功能异常,均为亚甲减。研究组甲状腺功能异常发生率高于对照组(14.2%比3.3%,P<0.01),研究组与对照组间FT3、TSH比较差异无统计学意义(P>0.05),研究组FT4低于对照组(P<0.05)。a、b组间GHb、空腹及餐后血糖、胆固醇、甘油三酯、高密度脂蛋白、血肌酐比较差异无统计学意义(P>0.05);b组低密度脂蛋白高于a组(P<0.05)。结论 2-DM患者中甲状腺功能与健康体检者相比其异常发生率明显增高,以亚甲减为主,女性居多。

Objective To investigate the thyroid function in patients with type 2 diabetes mellitus(2-DM) through a comparison with healthy subjects. Methods The concentrations of free T3(FT3),free T4(FT4) and thyroid stimulating hormone(TSH) were measured in 120 inpatients with 2-DM(study group) and 60 healthy subjects(control group).In addition,levels of blood glucose,glycosylated hemoglobin(GHb),cholesterol,triglyceride and creatinine were determined in study group.Results Among the 120 2-DM patients,103 had normal thyroid function and 17 had thyroid dysfunction.Among the 17 patients,15(12.5%) had subclinical hypothyroidism with a female predominance (18.3% vs 6.7%,P<0.05)and 2(1.7%) had subclinical hyperthyroidism.Among the 60 healthy subjects,2(3.3%) had subclinical hypothyroidism.Compared with control group,the incidence of thyroid dysfunction increased(14.2% vs 3.3%,P<0.01)and the levels of FT4 decreased in study group(P<0.05).There were no obvious differences in the levels of FT3 and TSH between the two groups(P>0.05).Compared with patients with normal thyroid function,the levels of low density lipoprotein significantly increased in patients with subclinical hypothyroidism(P<0.05).No obvious differences in levels of GHb,blood glucose,cholesterol,triglyceride,high density lipoprotein and creatinine between patients with normal thyroid function and patients with subclinical hypothyroidism(P>0.05). Conclusion The incidence of thyroid dysfunction,especially subclinical hypothyroid,in 2-DM patients is considerably higher than that in healthy subjects and there is a female predominance of thyroid dysfunction among 2-DM patients.