促甲状腺激素、同型半胱氨酸与2型糖尿病患者颈动脉内中膜厚度相关性研究

The relationship between TSH,Hcy and carotid intima-media thickness in type 2 diabetic patients

目的分析促甲状腺激素(thyroid stimulating hormone,TSH)、同型半胱氨酸(homocysteine,Hcy)与2型糖尿病患者颈动脉内中膜厚度(intima-media thickness,IMT)的关系。方法采用回顾性研究,纳入甲状腺功能正常IMT正常的2型糖尿病患者(40例)为观察组中的IMT正常组;纳入甲状腺功能正常IMT增厚的2型糖尿病患者(40例)为观察组中的IMT增厚组;纳入45例健康者为对照组。比较IMT正常组、IMT增厚组和对照组年龄、糖尿病病程、Hcy、TSH、血清总胆固醇(serum total cholesterol,TC)、体重指数(body mass index,BMI)、三酰甘油(triglyceride,TG)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、空腹血糖(fasting blood-glucose,FPG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、IMT、血肌酐(serum creatinine,Scr)水平。结果与对照组比较,IMT正常组年龄、FPG、Hcy、TSH、HbA1c水平显著升高,HDL-C降低,差异均有统计学意义(P<0.05)。与对照组比较,IMT增厚组年龄、BMI、FPG、TG、Hcy、TSH、HbA1c、IMT均显著升高,HDL-C显著降低,差异有统计学意义(P<0.05)。与IMT正常组比较,IMT增厚组年龄、BMI、MT、TG、FPG均升高,差异有统计学意义(P<0.05)。IMT与TSH为正相关性(r=0.312,P=0.048),与Hcy为正相关(r=0.986,P=0.002),与BMI为正相关(r=0.637,P=0.013)。结论2型糖尿病患者IMT受诸多因素影响,例如BMI、TG、FPG、TSH、Hcy等,其中Hcy、BMI、TSH是预测动脉粥样硬化的危险因素。

Objective To analyze the relationship between thyroid stimulating hormone(TSH),homocysteine(Hcy)and intima-media thickness(IMT)in patients with type 2 diabetes mellitus.Methods A retrospective study was conducted to enroll patients with normal thyroid function and normal IMT(40 cases).The normal IMT group was included in the observation group.Patients(40 cases)with normal thyroid function IMT thickening were included in the observation group,45 healthy people were included in the control group.The age,course of diabetes,Hcy,TSH,serum total cholesterol(TC),body mass index(BMI),triglyceride(TG),high density lipoprotein cholesterol(HDL-C)were compared between IMT normal group,IMT thickening group and control group low density lipoprotein cholesterol(LDL-C),fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),IMT and serum creatine(SCR)levels.Results Compared with the control group,the age,FPG,Hcy,TSH,HbA1c levels in the normal IMT group were significantly increased,and HDL-C was decreased.The above differences were statistically significant(P<0.05).Compared with the control group,age,BMI,FPG,TG,Hcy,TSH,HbA1c,IMT were significantly increased in the IMT thickening group,and HDL-C was significantly decreased,the difference was statistically significant(P<0.05).Compared with the normal IMT group,the IMT thickening group was older,and the BMI,MT,TG,and FPG were all increased,and the difference was statistically significant(P<0.05).IMT was positively correlated with TSH(r=0.012,P=0.048),positively correlated with Hcy(r=0.003,P=0.002),and positively correlated with BMI(r=0.069,P=0.013).Conclusion The carotid intima-media thickness of patients with type 2 diabetes is affected by many factors,such as BMI,TG,FPG,TSH,Hcy,etc.Among them,Hcy,BMI,TSH and IMT thickening are risk factors for predicting atherosclerosis.