糖尿病合并桥本甲状腺炎患者临床特征及甲状腺自身免疫对胰岛功能的影响

Clinical Characteristics of Patients with Diabetes Mellitus Complicated with Hashimoto's Thyroiditis and Effect of Thyroid Autoimmunity on Islet Function

目的探究2型糖尿病(T2DM)合并桥本甲状腺炎(HT)患者的临床特征,同时分析T2DM患者的胰岛功能受到甲状腺自身免疫功能的影响。方法选取2017年2月至2019年2月鲁中矿业有限公司医院收治的T2DM合并HT的62例患者临床资料,另取同期单纯T2DM患者62例,分析两组患者的相关指标;分析甲状腺免疫功能对胰岛功能造成的影响。结果与单纯T2DM患者相比,T2DM合并HT的患者血肌酐、C肽2 h水平、腰臀比以及舒张压均更差(P<0.05);单因素分析发现,C肽水平受到HT、冠心病、HDL-C、三酰甘油、肌酐、空腹血糖、糖化血红蛋白、腰围、BMI指数、糖尿病病程以及年龄的影响;多因素分析发现,HDL-C、空腹血糖、糖化血红蛋白、糖尿病病程以及HT都是导致T2DM患者胰岛功能差的独立危险因素。结论与单纯T2DM患者相比,T2DM合并HT的患者胰岛功能更差,HT是T2DM患者胰岛功能差的独立危险因素。

Objective To investigate the clinical features of type 2 diabetes mellitus(T2DM)complicated with Hashimoto thyroiditis(HT)and analyze the effect of thyroid autoimmunity on islet function in T2DM patients.Methods The clinical data of 62 patients with T2DM complicated with HT admitted from February 2017 to February 2019 were retrospectively analyzed,and 62 patients with T2DM alone in the same period were selected,and the related indexes of the two groups were analyzed.The effect of thyroid immune function on islet functionwas also analyzed.Results Compared with simple T2DM patients,serum creatinine and C-peptide in 2 hours,waist-hip ratio and diastolic blood pressure in T2DM patients with HTwere worse(P<0.05).Univariate analysis showed that C peptide levels were associated with HT,coronary heart disease,HDL-C,triacylglycerol,creatinine,fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),waist circumference,BMI index,anddiabetes duration and age.Multivariate analysis showed that FBG,HbA1c,diabetes durationand HT were all independent risk factors for poor islet function in patients with T2DM.Conclusion Compared with simpleT2DMpatients,the islet function inT2DM patients with HT is worse,and HT isthe independent risk factor for poor islet dysfunction in T2DM patients.