甲状腺功能正常的2型糖尿病患者血清甲状腺激素与胆红素的相关性分析

Association between serum thyroid hormones and serum total bilirubin in euthyroid patients with type 2 diabetes mellitus

目的分析甲状腺功能正常的2型糖尿病患者血清甲状腺激素水平与胆红素的关系。方法收集1 296例2型糖尿病患者的临床资料。按总胆红素水平三分位数分为T1组(≤9.60μmol/L),T2组(>9.60~13.61μmol/L)和T3组(>13.61μmol/L)。比较各组间甲状腺功能及临床指标的变化趋势。采用Pearson相关和多元线性回归分析甲状腺功能与胆红素的相关性。结果从T1组到T3组,男性、饮酒者比例、舒张压、血红蛋白、空腹血糖、餐后血糖、肝酶、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)呈升高趋势,年龄、病程呈下降趋势(均P<0.05)。Pearson相关分析显示胆红素与FT4和FT3均呈正相关(均P<0.05),与促甲状腺素无关(P>0.05)。多元线性回归分析显示,FT4、FT3均与胆红素呈正相关(均P<0.01)。胆红素随FT4或FT3的升高而逐组升高(均P<0.05)。结论在甲状腺功能正常的2型糖尿病患者中,血清胆红素水平与FT4、FT3呈正相关。

Objective To investigate the association between the levels of serum thyroid hormones and total bilirubin in euthyroid patients with type 2 diabetes mellitus(T2DM).Methods The consecutive medical records of 1296 inpatients with T2DM were collected at the Department of Endocrinology and Metabolism in Ningbo First Hospital from January 2013 to December 2017.Patients were classified into three groups according to the tertiles of total bilirubin:T1(≤9.60μmol/L),T2(>9.60~13.61μmol/L)and T3(>13.61μmol/L).One-way ANOVA and Kruskal-Wallis test were used to evaluate the trends of thyroid hormone and other clinical indicators.Pearson correlation analysis and multiple linear regression analysis were adopted to examine the relationships between thyroid hormone and serum total bilirubin.Results With the increase of serum total bilirubin from the lowest tertile to the highest tertile,the proportion of male and drinking,diastolic blood pressure,hemoglobin,fasting blood glucose,postprandial blood glucose,transaminases,free T4(FT4)and free T3(FT3)tended to increase(P<0.05);while the age and duration of T2DM tended to decrease(P<0.05).Pearson correlation analysis showed that total bilirubin level was positively correlated with FT4(P<0.05)and FT3(P<0.05)respectively,but not correlated with TSH(P>0.05).Multiple linear regression analysis showed that both FT4 and FT3 were positively correlated with serum total bilirubin(P<0.01).Total bilirubin was on the rise with increasing serum FT4 and FT3 from lowest tertile to highest tertile(P<0.05).Conclusion Low FT4 and FT3 levels are related to low serum total bilirubin in euthyroid T2DM patients.