2型糖尿病合并亚临床甲状腺功能减退患者临床特点分析

Analysis of clinical characteristics of patients with type 2 diabetes with subclinical hypothyroidism

目的:分析住院2型糖尿病合并亚临床甲状腺功能减退症(SCH)患者糖、脂及骨代谢特点。方法:将318例住院2型糖尿病患者按甲状腺功能分为亚临床甲减组和单纯糖尿病组两组,对比分析亚临床甲减组与单纯糖尿病组之间的临床资料及糖、脂及骨代谢等生化指标。结果:318例糖尿病患者中甲状腺功能异常的发生率为27.0%,其中亚临床甲减所占比例最高,约为19.5%;合并SCH患者的FT_3、FT_4、HbA1c、β-cross、PINP明显低于单纯2型糖尿病组(P<0.05),TSH、TC、TG、LDL水平较单纯2型糖尿病组明显升高(P<0.05)。TSH与患者年龄、BMI、LDL正相关,与HbA1c、BMD、β-cross、PINP负相关。结论:2型糖尿病患者中甲状腺功能异常的发生率较高,尤其以亚临床甲状腺功能减低为著,与单纯2型糖尿病患者比较合并亚临床甲状腺功能减低的患者更容易发生血脂及骨代谢的异常。

Objective:To explore the blood glucose,blood lipid and bone metabolic features of type 2 diabetes mellitus(T2DM)patients with subclinical hypothyroidism(SCH).Methods:A total 318hospitalized patients with type 2 diabetics were divided according to thyroid function,their clinical and pathological data of both type 2 diabetics and type 2 diabetics with SCH were retrospectively reviewed and analyzed.Results:The incidence of thyroid dysfunction was 27.0%.In all kinds of thyroid dysfunctions,the subclinical hypothyroidism has the highest percentage 19.5%.The level of HbA1c,FT 3,FT 4,β-cross and PINP in T2DM patients with subclinical hypothyroidism were lower than that of T2DM patients without thyroid dysfunction significantly(P<0.05),however,the age,BMI,level of TSH,TC,LDL were higher than in T2DM patients without thyroid dysfunction(P<0.05).TSH was positively associated with age、BMI and LDL and negatively associated withHbA1c,BMD,β-cross and PINP.Conclusion:Thyroid dysfunction is quite common in the T2DM,especially subclinical hypothyroidism.Compared:with the T2DM patients without thyroid dysfunction,the T2DM patients with subclinical hypothyroidism are more likely to suffer from metabolic disorder of blood fat and markers of bone turnover.