甲状腺功能正常的2型糖尿病患者甲状腺激素与糖化血红蛋白水平关系分析

Correlation between thyroid hormone and glycosylated hemoglobin in type 2 diabetic patients with normal thyroid function

目的探讨甲状腺功能正常的2型糖尿病患者甲状腺激素与糖化血红蛋白(glycosylated hemoglobin,HbA 1 c)水平的相关性。方法1077例2型糖尿病患者,收集其基本资料并检测血清游离三碘甲状腺原氨酸(free triiodothyroionine 3,FT 3)、游离甲状腺素(free thyroxine 4,FT 4)、血清促甲状腺激素(thyroid stimulating hormone,TSH)、HbA 1 c、空腹血糖等指标;采用多元线性回归分析甲状腺功能正常的2型糖尿病患者HbA 1 c水平的影响因素。结果1077例患者FT 3为4.35(4.00,4.73)pmol/L,FT 4为15.98(14.48,17.75)pmol/L,TSH为2.08(1.25,3.15)mu/L,FT 3/FT 4比值为0.27(0.24,0.31);FT 3、FT 3/FT 4对HbA 1 c有负影响(β=-0.276,P<0.001;β=-0.166,P<0.001),FT 4、TSH对HbA 1 c无影响(β=0.106,P=0.063;β=-0.015,P=0.320)。结论甲状腺功能正常的2型糖尿病患者甲状腺激素变化会对血糖水平产生影响。

Objective To explore the correlation between thyroid function and glycosylated hemoglobin(HbA 1 c)in type 2diabetes mellitus(T2DM)patients with normal thyroid function.Methods The clinical data of 1077patients with T2DM were collected and the serum levels of free triiodothyroionine 3(FT 3),free thyroxine 4(FT 4),thyroid stimulating hormone(TSH),HbA 1 c,and fasting plasma glucose were detected.The influence of thyroid hormone on HbA 1 c was analyzed by multivariate linear regression.Results The level of FT 3 of 1077patients was 4.35(4.00,4.73)pmol/L,FT 4 was 15.98(14.48,17.75)pmol/L,TSH was 2.08(1.25,3.15)mu/L,and FT 3/FT 4 was 0.27(0.24,0.31).FT 3 and FT 3/FT 4 negatively influenced HbA 1 c(β=-0.276,P<0.001;β=-0.166,P<0.001),while FT 4 and TSH had no influence on HbA 1 c(β=0.106,P=0.063;β=-0.015,P=0.320).Conclusion The changes in thyroid hormone can affect plasma glucose levels in T2DM patients with normal thyroid function.