甲状腺功能正常的2型糖尿病患者血清促甲状腺激素水平与早期动脉粥样硬化的相关性研究

Association between thyroid stimulating hormone and early atherosclerosis in newly diagnosed patients with type 2 diabetes mellitus and normal thyroid function

目的探讨甲状腺功能正常的2型糖尿病(T2DM)患者促甲状腺激素(TSH)与早期动脉粥样硬化的相关性。方法选取400例T2DM患者为研究对象,根据彩色多普勒超声检查结果,分为双侧颈动脉正常组(121例)、单侧颈动脉斑块组(142例)和双侧颈动脉斑块组(137例),收集空腹血样本用于血脂、血糖、尿酸等测定。结果双侧颈动脉斑块组和单侧颈动脉斑块组TSH、颈动脉内膜中层厚度(CIMT)和肱踝脉搏波传导速度(baPWV)均高于双侧颈动脉正常组(P<0.05);Pearson相关分析提示,在初诊T2DM患者中,CIMT和baPWV均与TSH呈正相关(r值分别为0.237、0.233,P<0.05);多元逐步回归分析提示,CIMT和ba PWV均与TSH密切相关(P<0.05)。结论血清TSH水平与CIMT和ba PWV密切相关,血清TSH水平可能是T2DM患者早期动脉粥样硬化的独立危险因素。

Objective To investigate the relationship between serum thyroid stimulating hormone level(TSH)and early atherosclerosis in newly diagnosed type 2 diabetes mellitus(T2DM)patients with normal thyroid function.Methods A total of 400 newly diagnosed T2DM patients were enrolled in our study and divided into the normal carotid artery group(n=121),the unilateral carotid plaque group(n=142),and the bilateral carotid plaque group(n=137).Their clinical,biochemical parameters,carotid intimal medial thickness(CIMT),brachial-Ankle pulse wave velocity(ba PWV)were all performed in these individuals.Results Compared with the normal carotid artery group,TSH,CIMT and ba PWV were higher in the unilateral carotid plaque and bilateral carotid plaque group(P<0.05),Pearson correlation analysis indicated that in the newly diagnosed T2DM patients,CIMT and ba PWV were positively correlated with TSH(r=0237,0.233,P<0.05);multiple stepwise regression analysis indicated that both CIMT and baPWV were closely related to TSH(P<0.05).Conclusion TSH is significantly correlated with CIMT and ba PWV in newly diagnosed T2DM.Therefore,TSH may have the potential to serve as biomarkers for early arteriosclerosis in T2DM with normal thyroid function.