2型糖尿病患者甲状腺功能变化的初步探讨

A preliminary study on the function of thyroid 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及其与各临床指标的关系。方法将211例2型糖尿病患者按促甲状腺素(TSH)水平分组,即TSH(μIU·mL-1)分为<0.3、0.3～、1.0～、2～和>5.5μIU·mL-1组。检测各组患者年龄、病程、体质指数(BMI)、血压、血糖、糖化血红蛋白、血脂及甲状腺激素水平,并进行相关性分析。结果患者BMI水平随TSH水平增加而增加,差异有统计学意义(P<0.05)。TSH 0.3～μIU·mL-1组与TSH 2～μIU·mL-1组FGB水平均较TSH 1.0～μIU·mL-1组明显减低,差异有统计学意义(P<0.05)。TSH 0.3～5.5μIU·mL-1正常参考值范围内的患者,FT4上四分位组TSH水平明显低于下四分位组TSH水平,差异有统计学意义(P<0.05)。患者TSH水平与FT3、FT4、FGB、HbA1c呈负相关,其与FT3、FT4的负相关有统计学意义(P<0.05)。TSH水平与年龄、病程、SBP、DBP、BMI、TC、TG呈正相关,其中与SBP、DBP、BMI水平的正相关有统计学意义(P<0.05)。结论测定甲状腺激素水平的变化对糖尿病患者的病情的评估、预后判断和病情控制具有重要的临床意义。

Objective To observe the change of serum thyroid hormone levels in patients with type 2 diabetes mellitus and its relationship with clinical indicators. Methods 211 patients were grouped according to TSH levels ： TSH （ μIU · mL^-1 ） 〈 0.3 group,0.3 group, 1.0 - group ,2 - and 〉 5.5 group. To detect the patient＇s age, disease duration, BMI, blood pressure, blood glucose, glycosylated hemoglobin,lipids and thyroid hormone levels, and analyzed the correlation of each index. Results The levels of BMI with type 2 diabetes pa- tients were increased with TSH levels, the difference was statistically significant （ P 〈 0. 05 ）. Compared with group TSH 1.0 -μIU · mL^-1, the FGB of group TSH 0.3 - μIU · mL^-1 and group TSH 2 -μIU · mL^-1 were significantly reduced （ P 〈 0.05 ）. The TSH levels of FT4 upper quartile significantly below the FT4 lower quartile within the normal referenee range in TSH 0.3-μIU · mL^-1, the differenee was statistically significant （ P 〈 0.05 ）. The levels of Fr3, FT4, FGB, HbA,, were negative correlated with TSH. FT3 , FT4 negative correlation was statistically significant （ P 〈 0.05 ）. The lever of age, disease duration, SBP, DBP, BMI, TC and TG were positively correlated with TSH. SBP, DBP, BMI was positive correlation （P 〈0. 05 ）. Conclusion Testing the changes of thyroid hormone levels is of great clinical signifieanee for assessment, prophylaxis judgement and situation control in diabetic patients.