初发儿童1型糖尿病患者甲状腺激素水平与糖脂代谢的相关性研究

Correlation between serum thyroid hormones with glucose and lipid metabolism in children with type 1 diabetes

目的探讨甲状腺功能正常的儿童1型糖尿病(type 1 diabetes mellitus,T1DM)者甲状腺激素水平与糖脂代谢相关指标的相关性。方法选取50例T1DM患儿,年龄6~12周岁,另选取健康体检的儿童71例作为正常对照组,收集其空腹血样本用于血糖、血脂、HbA1c、甲状腺激素水平等检测。结果T1DM患儿低密度脂蛋白-胆固醇(low density lipoprotein-cholesterol,LDL-C)、甘油三酯(triglyceride,TG)、空腹血糖(fasting blood glucose,FBG)和HbA1c高于健康对照组,而高密度脂蛋白-胆固醇(high density lipoprotein-cholesterol,HDL-C)、促甲状腺激素(thyroid stimulating hormone,TSH)和游离三碘甲状腺原氨酸(free triiodothyronine,FT3)低于健康对照组,且差异均有统计学意义(P<0.05)。Pearson相关分析提示,在T1DM患儿中,TSH与LDL-C(r=0.175,P=0.034)、总胆固醇(totalcholesterol,TC)(r=0.187,P=0.009)和TG(r=0.206,P=0.005)呈正相关,与FBG(r=-0.187,P=0.018)和HbA1c(r=-0.264,P<0.001)呈负相关。多元逐步回归分析结果显示TSH与TG(β=0.196,P=0.011)和HbA1c(β=-0.204,P=0.008)密切相关;FT3与TG(r=-0.185,P=0.012)、FBG(r=-0.193,P=0.007)和HbA1c(r=-0.215,P=0.002)呈负相关,多元逐步回归分析提示FT3与HbA1c(β=-0.192,P=0.014)密切相关;游离甲状腺素(free thyroxine,FT4)与TC、TG、LDL-C、HDL-C、FBG和HbA1c均无明显相关性。结论在T1DM患儿中TSH和FT3与糖脂代谢密切相关。

Objective To explore the correlation of serum thyroid hormones with glucose and lipid metabolism in children with type 1 diabetes (T1DM) whose thyroid functions with normal. Methods 50 T1DM and 71 healthy children were enrolled in our study. Their blood glucose, lipid, HbA1c and thyroid functions were determined. Results Compared with the control group, patients with T1DM had higher low density lipoprotein-cholesterol (LDL-C) , triglyceride (TG) , fasting blood glucose (FBG) and HbA1c while with lower high density lipoprotein-cholesterol (HDL-C) , thyroid Stimulating Hormone (TSH) , and free triiodothyronine (FT3) (P<0.05) . In children with T1DM, TSH was positively correlated with LDL-C (r=0.175, P=0.034) , total cholesterol (TC) (r=0.187, P=0.009) and TG (r=0.206, P=0.005) while negatively correlated with FBG (r=-0.187, P=0.018) and HbA1c (r=-0.264, P<0.001) . FT3 was negatively correlated with TG (r=-0.185, P=0.012) , FBG (r=-0.193, P=0.007) and HbA1c (r=-0.215, P=0.002) . But there were no correlations of FT4 with glucose or lipid metabolism. Conclusion TSH and FT3 are significantly correlated with glucose and lipid metabolism in children with T1DM.