不同性别甲状腺功能正常人群促甲状腺素与代谢综合征的相关性分析

The relationship of TSH and metabolic syndrome with its components in different sexual euthyroid health examination subjects

目的:探讨不同性别甲状腺功能正常人群促甲状腺素(TSH)与代谢综合征(MS)的关系,为防治提供临床依据。方法 :采用横断面研究,选取甲状腺功能正常者10 842例,男7 250例,女3 592例,测量身高、体重、血糖、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、尿酸(UA)、尿素氮(BUN)、肌酐(SCr)及甲状腺功能,计算体重指数(BMI)及预估肾小球滤过率(eGFR),分析TSH与MS的关系。结果:男、女MS患病率分别为20.1%、9.4%,MS组TSH水平均显著高于非MS组(男P=0.049,女P=0.009)。不同性别人群的TSH按四分位数分组,随着TSH的增加,MS的患病率升高,且符合MS诊断标准的项目数也显著增加(男P=0.05,女P<0.01)。在男性TSH,与年龄、SBP、UA、TG、SCr呈正相关,与HDL-C、eGFR呈负相关;在女性,TSH与年龄、SBP、DBP、UA、TG、LDL-C、TC、SCr、BMI呈正相关,与HDL-C、eGFR呈负相关。Logistic回归分析,校正年龄、尿酸、血糖、血脂后,男性TSH是MS的独立危险因素(P=0.043)。结论:在甲状腺功能正常的人群,尤其是男性人群中,TSH水平升高可能增加MS的患病风险,进而增加心血管疾病的发生风险。

Objective：To investigate the relationship of thyroid stimulating hormone （TSH） and metabolic syndrome （MS） with its components in different sexual subjects with normal euthyroid examination for preventing and curing metabolic syndrome and cardiovascular disease. Methods：We conducted a cross-sectional study of 10842 euthyroid subjects（male 7250,female 3592）. Height, weight, blood glucose, blood pressure （SBP, DBP）, blood lipid （TC, TG, HDL, LDL）, uric acid, renal function and thyroid function, body mass index （BMI）,estimated glomerular filtration rate （GFR） were mesured. The relationship between TSH and MS was analyzed. Results：The prevalence of MS in male and female was 20.1% and 9.4% ,respectively,and the TSH level in MS group was significantly higher than that in non MS group （male P=O.O49;female P=O.O09）. Subjects were stratified according to quartiles of TSH level. The higher the TSH,the higher the prevalence of MS. With the increase of TSH,abnormal metabolism components also significantly increased （male P=0.05;female P=0.00）. In males,TSH and TG,SBP was positively correlated （P=0.009,0.018）. In females,TSH and SBP, DBP,TG, BMI were positively correlated （P=-0.000,0.008,0,0）, and HDL was negatively correlated （P=0.022）. Logistic regression analysis showed that the TSH level was the independent risk factor for MS in male subjects after adjusting for age, uric acid,blood glucose and blood lipids （P=0.043）. Conclusion：In the subjects with normal euthyroid function,especially male, the increase of TSH level may be related to the increase risk of MS, and then increase the risk of cardiovascular disease.