2型糖尿病对甲减患者血脂心功能及心血管事件的影响

Effects of Type 2 Diabetes Mellitus on Blood Fat, Cardiac Function and Cardiovascular Disease with Hypothyroidism

目的:探讨2型糖尿病对甲减患者血脂、心功能及心血管事件的影响。方法:回顾性分析2015年4月到2018年4月在本院被确诊的344例SCH患者,根据患者是否合并T2DM,将其分为T2DM-SCH组64例和SCH组280例。回顾性分析患者的年龄、性别、体重指数(BMI)等一般资料,检测FPG、OGTT2h血糖(2hPG)、糖化血红蛋白(HbA1c)浓度、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)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、左心室收缩功能(LVEF)和舒张功能(E/A);记录两组患者心血管疾病并发情况。结果:与SCH组相比,T2DM-SCH组患者血清FPG、2hPG、HbA1c、TC、TG、HDL-C、LDL-C、SBP和DBP水平均显著升高(P<0.05),心功能LVEF和E/A水平均显著下降(P<0.05);T2DM-SCH组共发生31(48.44%)例心血管事件,SCH组共发生76(27.14%)例心血管事件,两组间差异具有统计学意义(χ^2=14.752,P=0.005)。结论:T2DM可以增加SCH患者发生脂代谢紊乱、心功能减退、心血管不良事件的风险。

Objective: To explore the effects of type 2 diabetes mellitus (T2DM) on cardiovascular-related complications in patients with subclinical hypothyroidism (SCH). Methods: 344 patients with SCH who were diagnosed in our hospital from April 2015 to April 2018 were retrospectively analyzed and were divided into T2DM-SCH group (64 cases) and SCH group (280 cases) according to whether patients were complicated by T2DM. The general data of age,gender and body mass index (BMI) were retrospectively analyzed,and the FPG,OGTT 2h blood glucose (2hPG),glycosylated hemoglobin (HbA1c) concentration,total cholesterol (TC),triglyceride (TG),low-density Lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),free triiodothyronine (FT3),free thyroxine (FT4),thyroid-stimulating hormone (TSH),left ventricular systolic function (LVEF) and diastolic function (E/A) were detected,The complications of cardiovascular diseases were recorded in the two groups. Results: Compared with SCH group,the levels of serum FPG,2hPG,HbA1c,TC,TG,HDL-C,LDL-C,SBP and DBP were significantly increased in T2DM-SCH group (P<0.05) while the levels of cardiac function LVEF and E/A were decreased significantly (P<0.05). There were 31 cases (48.44%) of cardiovascular events in T2DM-SCH group and 76 cases (27.14%) of cardiovascular events in SCH group (χ^2=14.752,P=0.005). Conclusions: T2DM can increase the risk of lipid metabolism disorder,cardiac dysfunction,and cardiac adverse events in SCH patients.