血清25-羟维生素D水平与2型糖尿病患者甲状腺功能的相关性研究

Relationship between Thyroid Function and Serum 25-OH Vitamin D levels in Type 2 Diabetic Patients

目的探讨血清25-羟维生素D水平[25(OH)D]与2型糖尿病患者甲状腺功能的关系.方法选取2型糖尿病患者200例为研究对象,通过酶联免疫吸附试验检测血清25(OH)D水平,根据血清25(OH)D不同水平分为充足组、不足组、缺乏组和严重缺乏组.比较4组患者血糖代谢及甲状腺功能代谢指标水平.结果200例患者中,维生素D充足21例(10.50%),维生素D不足37例(18.50%),维生素D缺乏53例(26.50%),维生素D严重缺乏89例(44.50%);缺乏组、严重缺乏组2型糖尿病病程均高于充足组(P<0.05);四组患者血钙及空腹胰岛素、空腹血糖、HOMA-IR、HbAlc水平比较差异无统计学意义(P>0.05);严重缺乏组TSH、FT3、TT3水平均明显高于充足组,缺乏组FT3水平明显高于充足组(P<0.05);相关分析显示,25(OH)D与TSH呈显著负相关(r<0,P<0.05);多元线性逐步回归分析显示,25(OH)D是预测TSH水平的独立危险因素(β=-0.227,P<0.05).结论2型糖尿病患者血清25(OH)D水平明显降低,25(OH)D与2型糖尿病患者甲状腺功能有一定关系.

Objective To investigate the relationship between thyroid function and serum 25-OH Vitamin D[25(OH)D]levels in type 2 diabetic patients.Methods 200 patients with type 2 diabe-tes were selected as the research subject.The serum 25(OH)D levels were measured by en-zyme-linked immunosorbent assay(ELISA)and according to different levels of serum 25(OH)D,the patients were divided into sufficient group,insufficient group,deficient group and severely deficient group.The levels of blood glucose metabolism and thyroid function were compared between the four groups.Results Among 200 patients,21 cases(10.50%)had suffi-cient vitamin D,37 cases(18.50%)had insufficient vitamin D,53 cases(26.50%)had deficient vitamin D,and 89 cases(44.50%)had severely deficient vitamin D.The duration of type 2 dia-betes in the deficient group and severely deficient group was higher than that in sufficient group(P<0.05).There was no significant difference in the levels of blood calcium,fasting insulin,fast-ing blood glucose,HOMA-IR,and HbAlc between the four groups(P>0.05).The levels of TSH,FT3 and TT3 in severely deficient group were significantly higher than those in the sufficient group,and the FT3 level in deficient group was significantly higher than that in the sufficient group(P<0.05).Correlation analysis showed that 25(OH)D was significantly negatively corre-lated with TSH(r<0,P<0.05).Multiple linear stepwise regression analysis showed that 25(OH)D was an independent risk factor for predicting TSH levels(β=-0.227,P<0.05).