2型糖尿病患者合并低T_3综合征与糖化血红蛋白和胰岛β细胞功能相关性的研究

Association analysis between low T_3 syndrome and HbA_1c,HOMA-β in patients with type 2 diabetes

目的探讨住院T2DM患者合并低T3综合征发生率、临床特点和相关危险因素。方法249例T2DM患者根据甲状腺功能分为单纯T2DM(T2DM)组和T2DM合并低T3综合征(T2DM-LT3)组。检测HbA1c、FPG、FC-P、总三碘甲状腺原氨酸(TT3)、血清总甲状腺素(TT4)和促甲状腺激素(TSH)等指标。结果 T2DM-LT3组FC-P和胰岛β细胞功能指数(HOMA-β)低于T2DM组,糖尿病酮症发生率、HbA1c和FPG高于T2DM组(P<0.05)。Pearson相关分析显示,TT3与HOMA-β和FC-P呈正相关(r=0.192、0.174,P<0.01);与HbA1c、FPG和糖尿病酮症呈负相关(r=-0.319、-0.222、-0.202,P<0.01)。Logistic回归分析显示,FC-P、TG和HbA1c是发生低T3综合征的危险因素。结论T2DM患者中低T3综合征可能与血糖控制不佳和胰岛功能受损相关。

Objective To investigate the prevalence and clinical characteristics of low T3 syndrome in hospitalized patients with type 2diabetes. Methods A total of 249 type 2diabetic patients were enrolled in this study and divided into two groups according to their thyroid function：T2DM with normal thyroid function（T2DM group）and T2 DM with low T3syndrome（T2DM-LT3group）.HbA1 c,FPG,FC-P,TT3,TT4 and TSH were measured in all subjects. Results FC-P and HOMA-βwere significantly lower in T2DM-LT3 group than in T2 DM group.The prevalence of diabetic ketosis,HbA1 c and FPG were significantly higher in T2DM-LT3 group than in T2 DM group（P〈0.05）.Pearson analysis showed that TT3 was positively correlated with HOMA-β（r=0.192,P=0.000）and FC-P（r=0.174,P=0.006）,and negatively correlated with HbA1c（r=-0.319,P=0.000）,FPG（r=-0.222,P=0.000）,and incidence of diabetic ketosis（r=-0.202,P=0.001）.Logistic regression analysis showed that FC-P,TG,and HbA1 c were independent risk factors for low T3 syndrome. Conclusion Low T3 syndrome may be associated with poor glycaemic control and damage of isletβcell in patients with type 2diabetes.