2型糖尿病病人甲状腺相关激素水平与冠心病的关联分析

The association of coronary heart disease and the value of the thyroid related hormones of type 2 diabetic patients

目的探讨2型糖尿病病人甲状腺相关激素水平与冠心病之间的关联。方法选取2016年3月至2018年6月滁州市中西医结合医院糖尿病病人360例,分为冠心病组80例,非冠心病组280例,测量两组病人血清甲状腺激素水平及其他生化指标含量,使用logistic回归分析两组病人血清甲状腺相关激素水平与冠心病发生的关系,并使用多元线性回归分析2型糖尿病病人冠脉病变程度的可能影响因素。结果在年龄、性别均衡可比的情况下,冠心病组病人血清促甲状腺激素(TSH)水平为(3.80±1.63)ng/L,高于非冠心病组的(1.91±0.67)ng/L,而血清游离三碘甲状腺原氨酸(FT3)水平小于非冠心病组(3.79±0.49)pg/L比4.19±0.43)pg/L。logistic回归分析结果显示:血清TSH水平较高的病人发生冠心病的OR值为2.02(1.38~2.97),而FT3水平较低的病人发生冠心病的OR值为1.32(1.15~1.71)。多元线性回归结果显示高血压、TSH、低密度脂蛋白胆固醇(LDL-C)水平为冠心病病人冠脉狭窄程度的独立影响因素(P<0.05)。结论 2型糖尿病病人血清TSH、FT3水平与冠心病发病风险之间存在关联,同时TSH也与冠心病病人冠脉病变程度有关。

Objective To explore the association of coronary heart disease(CHD)and the value of the thyroid related hormones of type 2 diabetic patients.Methods 360 diabetic patients of a department of endocrinology in one hospital were selected as study subjects,235 patients were male and 125 were female.The average ages of the patients were(64.5±10.3)years old.A total of 80 cases of CHD were recruited in our study.And 280 cases were free of CHD.The serum levels of thyroid related hormones and other biochemical indexes of patients were measured.The independent association between the serum thyroid related hormones and risk of CHD was analyzed by logistic regression,and the possible influencing factors of the degree of coronary artery lesions were analyzed by multiple linear regression.Results There was no significant difference in characteristics of age and gender between CHD and control group.The level of serum TSH in the CHD group was(3.80±1.63)ng/L,which was significantly higher than that in the control group(1.91±0.67)ng/L.But the level of serum FT3 was lower than the control group(3.79±0.49 vs. 4.19±0.43)pg/L.The binary logistic regression analysis indicated that the OR of the risk of CHD was 2.02(1.38-2.97)and 1.32(1.15-1.71)for patients with higher level of serum TSH and lower serum FT3.The results of multiple linear regression analysis show that the high blood pressure,serum TSH and LDL-C level were the independence influencing factors for the degree of coronary artery lesions(P<0.05).Conclusion The levels of serum TSH,FT3 was associated with CHD of type 2 diabetes mellitus.