2型糖尿病患者甲状腺功能与血小板参数的相关性研究

Relationship between thyroid function and platelet indexes in patients with type 2 diabetes mellitus

目的：研究2型糖尿病（T2DM）患者甲状腺功能与血小板（PLT）参数的相关性。方法选择2013年1～4月首都医科大学附属北京朝阳医院T2DM患者共333例，根据促甲状腺激素（TSH）将患者分为亚临床甲腺功能减退症（SCH）组和甲状腺功能正常（ET）组。研究的代谢指标包括体重指数、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、三酰甘油（TG）、糖化血红蛋白（HbA1c）和空腹血糖；PLT参数包括PLT、PLT分布宽度（PDW）、平均血小板体积（MPV）和大PLT比率（P-LCR）。甲状腺功能检测包括游离三碘甲状腺原氨酸、游离甲状腺素和TSH。结果 SCH组的PDW、MPV、P-LCR和TG分别为（14.43±2.28）fl、（11.47±0.99）fl、（36.61±8.10）%和（3.19±1.96）mmol/L，ET组相应为（13.02±1.89）fl、（10.74±0.89）fl、（30.70±7.21）%和（1.87±1.51）mmol/L，SCH组上述指标均明显高于ET组（均P〈0.01）。多元线性回归分析发现，HbA1c和TSH均是影响PDW、MPV以及P-LCR的因素（P〈0.05或P〈0.01）。结论 T2DM患者易出现血栓相关并发症并且其发生与PLT活性密切相关。 PLT活性与TSH水平呈正相关，TSH升高会增加T2DM患者合并心脑血管疾病的风险。

Objective To study the relationship between thyroid function and platelet （PLT） indexes in patients with type 2 diabetes mellitus （T2DM）. Methods From January to April 2013, 333 T2DM patients admitted to Beijing Chaoyang Hospital, Capital Medical University were enrolled. Based on the level of thyroid stimulating hormone （TSH）, all pa-tients were assigned into subclinical hypothyroidism （SCH） group or euthyroid （ET） group. Metabolism indexes included body mass index, total cholesterol, low density lipoprotein cholesterin, high density lipoprotein cholesterin, triglyceride （TG）, hemoglobin A1c （HbA1c） and fasting plasma glucose were tested, also PLT indexes included PLT, PLT distribution width （PDW）, mean PLT volume （MPV） and PLT-large cell ratio （P-LCR） were tested. Assay of thyroid function includ-ed free tri-iodothyronin, free thyroxine and TSH. Results PDW, MPV, P-LCR and TG [（14.43±2.28） fl, （11.47±0.99） fl, （36.61±8.10）%and （3.19±1.96） mmol/L] were found significant increased in SCH group compare to ET group [（13.02±1.89） fl, （10.74±0.89） fl, （30.70±7.21）%, （1.87±1.51） mmol/L], with statistically significant difference （P〈 0.01）. Logis-tic regression showed that TSH and HbA1c were the influencing factors of PLT indexes （PDW, MPV, P-LCR） in T2DM patients （P〈 0.05 or P〈 0.01）. Conclusion T2DM patients are prone to have thrombotic complications, and complica-tions are closely related with activity of PLT. High activity of PLT is positive correlated with level of TSH, increased TSH can increase the risk of developing cardiovascular diseases.