脂代谢异常人群亚临床甲状腺功能减退患病率及相关因素分析

Analysis of the prevalence of subclinical hypothyroidism and related factors in a population with abnormal lipid metabolism

目的探讨脂代谢异常人群亚临床甲状腺功能减退(SCH)的患病特点及危险因素。方法对甘肃省内2463例汉族成年居民进行调查,记录受试者一般资料、生化指标和甲状腺功能,χ^(2)检验分析脂代谢异常人群SCH的患病情况,logistic回归分析脂代谢异常人群患SCH的危险因素。结果共纳入调查对象2463例(男1299例,女1164例),总人群中脂代谢异常503例,SCH患病538例。脂代谢异常人群中SCH患病率明显高于正常人群(26.64%vs 20.16%,P=0.004),SCH组年龄、体质量指数(BMI)、收缩压(SP)、舒张压(DP)、空腹血糖(FPG)、口服葡萄糖耐量试验(OGTT)负荷后2 h血糖(2 h PG)、总胆固醇(TG)、甘油三酯(TC)、低密度脂蛋白胆固醇(LDL-C)、谷草转氨酶(AST)、血磷(P)、糖化血红蛋白(HbA1c)、抗甲状腺过氧化物酶抗体(TPOAb)和抗甲状腺球蛋白抗体(TgAb)均高于正常组,尿酸(UA)低于正常组(均P<0.05)。TC和LDL-C水平正常、升高与异常3组间SCH患病率差异有统计学意义。Logistic回归分析显示,增龄、高SP、高FPG、高2 h PG为SCH的危险因素,男性为保护因素。结论脂代谢异常与SCH的发生密切相关,患病情况在女性中更为突出,应重视其防治。

Objective To investigate the characteristics and risk factors of subclinical hypothyroidism(SCH)in patients with abnormal lipid metabolism.Methods A total of 2463 Han adults in Gansu province were investigated.Their general information,biochemical parameters,and thyroid function were recorded.The χ^(2) test was used to analyze the prevalence of SCH in patients with abnormal lipid metabolism,while logistic regression was used to analyze the risk factors of SCH in patients with abnormal lipid metabolism.Results A total of 2463 subjects(1299 men,1164 women)were included in the study;of them,503 had abnormal lipid metabolism and 538 had SCH disease.The prevalence of SCH in the abnormal lipid metabolism group was significantly higher than that in the normal population(26.64%vs 20.16%,P=0.004).Mean SCH group age,body mass index,systolic blood pressure(SP),diastolic blood pressure,fasting plasma glucose(FPG),blood glucose 2 hours after an oral glucose tolerance test(2-h PG),triglyceride,total cholesterol(TC),low-density lipoprotein(LDL-C),aspartate aminotransferase,serum phosphorus,hemoglobin A1 c,thyroid peroxidase antibody,and thyroglobulin antibody levels were higher than those in the normal group,while uric acid level was lower than that of the normal group(all P<0.05).The prevalence of SCH in normal,elevated and the abnormal TC and LDL-C groups was statistically significant.A logistic regression analysis showed that aging and high SP,high FPG,high 2-h PG levels were risk factors,whereas male sex was a protective factor.Conclusion Abnormal lipid metabolism is closely related to the occurrence of SCH,which is more prominent in women.Attention should be paid to the prevention and treatment of SCH.