2型糖尿病患者血清甲状腺激素水平的变化及临床意义探讨

The Changes and Clinical Significance of Serum Thyroid Hormone in Patients with Type 2 Diabetes Mellitus

目的了解2型糖尿病患者血清甲状腺激素水平的变化情况,并探讨其临床意义。方法选择2013年1月至2014年8月间在我院就诊的120例2型糖尿病患者,运用放射免疫技术检测血清中游离三碘甲状腺原氨酸（FT3）、游离甲状腺激素（FT4）以及促甲状腺激素含量（TSH）,并与我院体检中心120例健康体检者进行比较;将120例糖尿病患者依据糖化血红蛋白水平的高低分为四组：〈5.5%组,5.5%~6.5%组,6.6%~9.5%组,〉9.5%组,并测定甲状腺激素水平。结果 2型糖尿病患者FT3明显低于正常组,差异有统计学意义（P〈0.05）,而FT4及TSH与正常组相比差异无统计学意义（P〉0.05）。糖化血红蛋白水平在5.5%~6.5%组、6.6%~9.5%组、〉9.5%组FT3含量明显低于〈5.5%组,差异有统计学意义（P〈0.05）;而糖化血红蛋白水平中FT4与TSH各组比较差异无统计学意义（P〉0.05）。结论糖尿病患者血清甲状腺激素水平主要是FT3含量下降,其下降程度和糖尿病的严重程度成正比,因此,血清FT3水平可作为评价糖尿病患者病情严重程度的重要指标之一。

Objective To investigate the changes of serum thyroid hormone in the patients with type 2 diabetes mellitus and its clinical significance. Methods A total of 120 patients with type 2 diabetes mellitus and 120 cases of healthy control were collected. The serum thyroid hormone including free triio- dothyronine （ FT3 ）, free thyroxine （FT4 ）, and thyrotrophin （TSH） were measured by radioimmunoassay method. The levels of serum thyroid hormone were compared between the two groups. Moreover, 120 patients with diabetes mellitus were divided into four groups based on the levels of glycated hemoglobin as following： 〈 5.5%, 5.5% -6.5%, 6.6%-9.5% , 〉9.5% , and thyroid hormone levels were measured. Results The serum FF3 levels in patients with type 2 diabetes mellitus were significantly lower than that of controls （P 〈 0. 05 ）. There was no significantly difference in terms of FT4 and TSH between two groups （ P 〉 0.05 ）. The serum FI＇3 levels in patents with type 2 diabetes mellitus with glyeated hemoglobin in the range of 5.5% -6.5%, 6.6%-9.5%, 〉 9.5 % were significantly lower than that of 〈 5.5 % group （P 〈 0.05 ）. However, there was no significantly difference in term of FT4 and TSH between those groups （P 〉 0.05 ）. Conclusion The levels of serum thyroid hormone in diabetes patients mainly showed FT3 level reduce, which was directly proportional to the severity of the diabetes. Therefore, the serum FT3 could be used as an important index in the evaluation of severity of diabetes.