亚临床甲减对糖尿病患者血糖血脂尿酸的影响

Effects of Subclinical Hypothyroidism on Blood Glucose,Blood Lipid and Uric Acid in Diabetic Patients

目的:观察分析亚临床甲减(亚临床甲状腺功能减退症)对糖尿病患者血脂水平、血糖水平、尿酸水平变化的影响。方法:选取2018年2月~2021年3月某院接收的138例糖尿病患者作为研究对象,根据糖尿病患者血清TSH(促甲状腺素)水平作为分组依据,其中血清TSH升高(>4.5uU/mL)的患者纳入研究组(41例),血清TSH正常(≤4.5uU/mL)的患者纳入常规组(97例)。对比分析两组总胆固醇、三酰甘油、高密度与低密度脂蛋白、BMI指数、餐后2h血糖、空腹血糖、糖化血红蛋白、尿微量白蛋白、尿酸以及并发症发生率。结果:研究组总胆固醇、三酰甘油、高密度与低密度脂蛋白等血脂指标水平高于常规组(P<0.05);研究组餐后2h血糖、空腹血糖、糖化血红蛋白等血糖指标水平高于常规组(P<0.05);研究组尿酸、BMI指数、尿微量白蛋白水平及并发症总发生率明显高于常规组(P<0.05)。Logistic多元回归分析结果显示,尿酸、高密度与低密度脂蛋白升高是导致血清TSH水平升高的独立危险因素(P<0.05)。结论:亚临床甲状腺功能减退症的发生,会严重影响到糖尿病患者血脂水平、血糖水平、尿酸水平,使其并发症增多,这就需要现代临床加强监测、及时治疗,帮助糖尿病患者维持稳定的甲状腺功能,从而减轻对糖尿病发展进程的不良影响。

Objective:To observe and analyze the effects of subclinical hypothyroidism(subclinical hypothyroidism)on the changes of blood lipid level,blood glucose level and uric acid level in diabetic patients.Methods:138 patients with diabetes treated in a hospital from February 2018 to March 2021 were selected as subjects.According to the level of serum TSH(thyroid stimulating hormone)in patients with diabetes,the patients with serum TSH increased(>4.5uU/mL)were included in the study group(41 cases),and patients with normal serum TSH(≤4.5uU/mL)were included in the conventional group(97 cases).The total cholesterol,triglyceride,high-density and low-density lipoprotein,BMI,2h postprandial blood glucose,fasting blood glucose,glycated hemoglobin,urinary microalbumin,uric acid and the incidence of complications were compared and analyzed between the two groups.Results:The levels of total cholesterol,triglyceride,high density lipoprotein and low density lipoprotein in the study group were higher than those in the control group(P<0.05).The levels of 2h postprandial blood glucose,fasting blood glucose and HbA1c in the study group were higher than those in the conventional group(P<0.05).Uric acid,BMI,urinary microalbumin and total incidence of complications in the study group were significantly higher than those in the conventional group(P<0.05).Logistic multiple regression analysis showed that increased uric acid,high density lipoprotein and low density lipoprotein were independent risk factors for elevated serum TSH level(P<0.05).Conclusion:The incidence of subclinical hypothyroidism can seriously affect the blood lipids,blood glucose,and uric acid levels in patients with diabetes,and make its complications increase,which requires strengthening modern clinical monitoring and timely treatment to help to maintain the stability of the thyroid function in patients with diabetes,so as to reduce the adverse impact on the development of diabetes.