甲状腺功能异常对2型糖尿病患者骨代谢及胰岛素抵抗的影响

Effect of Thyroid Dysfunction on Bone Metabolism and Insulin Resistance of Patients with Ⅱ Diabetes Mellitus

目的 :观察甲状腺功能异常对2型糖尿病患者骨代谢及胰岛素抵抗的影响。方法:选取2012年2月~2015年7月我院内分泌科收治的2型糖尿病患者300例为研究对象,将150例甲状腺功能正常2型糖尿病患者作为研究组,150例2型糖尿病合并甲状腺功能异常患者作为对照组,检测并比较两组患者清晨空腹状态下特异性碱性磷酸酶(BAP)、N-端中段骨钙素(N-MID-OT)、总1型胶原氨基端延长肽(T-P1NP)、B-胶原特殊序列(β-CTX)、25羟维生素D水平[25(OH)2D3]含量,同时测定两组患者血清中空腹血糖(FPG)、空腹胰岛素(FINS),计算并比较胰岛素抵抗指数(HOMA-IR)大小。结果:观察组患者血清N-MID-OT、BAP、T-P1NP、β-CTX含量均显著高于对照组患者,25(OH)2D3明显低于对照组患者,差异均有统计学意义(P<0.05);观察组患者FBG、FINS及HOMA-IR均明显高于对照组,差异有统计学意义(P<0.05)。结论:甲状腺功能异常可加剧T2DM患者骨转换及骨量丢失,增加患者发生骨质疏松风险,同时明显影响T2DM患者血糖代谢,加剧胰岛素抵抗,临床上应引起重视。

Objective:To observe the effect of thyroid dysfunction on bone metabolism and insulin resistance of patients withⅡdiabetes mellitus.Methods:In total,300patients withⅡdiabetes mellitus were admitted and treated in our hospital from February2012to July2015as the objects of study.They were randomly divided into test group and control group with150patients in each group.The bone alkaline phosphatase(BAP),N-MID-OT,T-P1NP,β-CTX,and25(OH)2D3were compared in two groups.The fasting plasma glucose(FPG),and the fasting insulin(FI)were measured in two groups,and the HOMA-IR was calculated.Results:The N-MID-OT、BAP、T-P1NP、β-CTX,FBG,FI and HOMA-IR in test group were significantly higher than those in control group,but the25(OH)2D3in test group was significantly lower than that in control group(P<0.05).Conclusions:Thyroid dysfunction can compound bone turnover and bone loss,increase the risk of osteoporosis,affect blood glucose,and exacerbate insulin resistance,to which should be paid attention.