2型糖尿病患者中亚临床甲状腺机能减退症与骨密度关系的临床研究

CLINICAL STUDY OF THE RELATIONSHIP BETWEEN SUBCLINICAL HYPOTHYROIDISM AND BONE MINERAL DENSITY IN THE PATIENTS WITH TYPE 2 DIABETES

目的探讨2型糖尿病患者中亚临临甲状腺机能减退症与骨密度关系。方法选择32例2型糖尿病合并亚临临甲状腺功能减退患者作为观察组,36例甲状腺功能正常的2型糖尿病患者作为对照组,比较两组间腰椎1、2、3、4椎体和左侧股骨颈等部位的骨密度(BMD)。结果两组间在年龄、性别、BMI、糖尿病病程、糖化血红蛋白、FT3、FT4均无明显差异,观察组中TC、TG、LDL-C、HOMA-IR、TSH高于对照组,而HDL-C低于对照组,观察组左侧股骨颈BMD低于对照组,差异有统计学意义,两组间腰椎1、2、3、4椎体BMD无明显差异。结论 2型糖尿病合并亚临临甲减者存在股骨颈的骨密度降低,胰岛素抵抗明显,同时存在血脂代谢紊乱。

Objective： To investigate relationship between subclinical hypothyroidism（SCH） and bone mineral density（BMD） in the patients with type 2 diabetes. Methods： Totally 68 patients with type 2 diabetes were divided into observation group（type 2 diabetic patients with SCH group,n=32） and control group（type 2 diabetic patients with euthyroid,n=36）. The patient＇s general information,past medical history,laboratory test results,lumbar vertebrae 1-4 and left femoral neck BMD using dual-energy X-ray absorptiometry were analyzed. Results： There were no significant difference in age,sex,BMI,duration of diabetes,Glycosylated hemoglobin（Hb A1c）,serum free triiodothyronine（FT3） level,serum free thyroxine（FT4） level between two groups. The total cholesterol,triglycerides,LDL cholesterol,homeostasis model assessment index for insulin resistance（HOMA-IR）,thyroid stimulating hormone（TSH） in observation group was significantly higher than those in control group,but significantly lower for the HDL cholesterol and the femoral neck BMD,and there was no significant difference of lumbar vertebrae 1-4 BMD between two groups. Conclusion： Type 2 diabetic patients with SCH are associated with lower femoral neck BMD,heavier insulin resistance and dyslipidemia.