老年2型糖尿病合并临床甲状腺功能减退及亚临床甲状腺功能减退患者血清apelin水平变化及意义

Changes and significance of serum apelin levels in elderly type 2 diabetes mellitus patients with clinical hypothyroidism and subclinical hypothyroidism

目的探究老年2型糖尿病(T2DM)合并临床甲状腺功能减退(OH)及亚临床甲状腺功能减退(SCH)患者血清孤独G蛋白耦联受体配体(apelin)水平变化及意义。方法前瞻性选取2019年1月至2021年1月南京中医药大学附属南京市中西医结合医院收治的150例老年T2DM患者作为研究对象,检测患者甲状腺功能指标,根据检测结果将患者分为OH组(n=44)、SCH组(n=47)与正常对照组(n=59)。检测3组血糖、血脂及甲状腺功能指标并予以对比,分析患者血清apelin与糖脂代谢指标及甲状腺功能指标的相关性,对患者发生OH、SCH的因素进行多因素Logistic回归分析。结果OH组空腹血糖(FBG)、糖化血红蛋白(HbA1c)、甘油三酯、总胆固醇、低密度脂蛋白胆固醇(LDL-C)、促甲状腺激素(TSH)、apelin均高于正常对照组,高密度脂蛋白胆固醇(HDL-C)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)均低于正常对照组,差异均有统计学意义(P<0.05);OH组HbA1c、总胆固醇、LDL-C、TSH、apelin均高于SCH组,HDL-C、FT4、FT3均低于SCH组,差异均有统计学意义(P<0.05)。老年T2DM患者血清apelin与FPG、HbA1c、甘油三酯、总胆固醇、TSH呈正相关(P<0.05),与FT4、FT3呈负相关(P<0.05)。多因素Logistic回归分析显示,老年T2DM患者发生OH、SCH与FPG、总胆固醇、HDL-C、FT4、FT3、TSH、apelin独立相关(P<0.05)。结论血清apelin水平在老年T2DM合并OH及SCH患者中呈现出高表达,且与患者糖脂代谢指标、甲状腺功能指标密切相关,应予以高度重视。

Objective To explore the changes and significance of serum orphan G protein-coupled receptor ligand(apelin)levels in elderly patients with type 2 diabetes mellitus(T2DM)combined with clinical hypothyroidism(OH)and subclinical hypothyroidism(SCH).Methods Prospectively select 150 elderly T2DM patients in Nanjing Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine from January 2019 to January 2021 as the research objects,the thyroid function indicators of the patients were tested,according to the test results the patients were divided into the OH group(n=44),the SCH group(n=47)and the normal control group(n=59),the three groups of blood glucose,blood lipids and thyroid function indexes were detected and compared,and the correlation between the patient's serum apelin and the glucose and lipid metabolism indexes and thyroid function indexes was analyzed,and the factors of the patients with OH and SCH Perform multivariate logistic regression analysis.Results The fasting blood glucose(FBG),hemoglobin A1c(HbA1c),triglyceride,total cholesterol,low density lipoprotein cholesterol(LDL-C),thyroid stimulating hormone(TSH)and apelin in the OH group were higher than those in the normal control group,while high density lipoprotein cholesterol(HDL-C),free thyroxine(FT4)and free triiodothyronine(FT3)were lower than those in the normal control group,and the differences were statistically significant(P<0.05);HbA1c,total cholesterol,LDL-C,TSH,and apelin in the OH group were higher than those in the SCH group,and HDL-C,FT4,and FT3 were lower than those in the SCH group,and the differences were statistically significant(P<0.05).The serum apelin and FPG,HbA1c,triglycerides,total cholesterol,TSH of elderly patients with T2DM were positive correlation,negatively correlated with FT4 and FT3(P<0.05).Multivariate Logistic regression analysis showed that the occurrence of OH and SCH in elderly patients with T2DM were independently correlated with FPG,total cholesterol,HDL-C,FT4,FT3,TSH,and apelin(P<0.05).Conclusion Serum apelin levels are highly expressed in elderly patients with T2DM combined with OH and SCH,and are closely related to the indicators of glucose and lipid metabolism and thyroid function,which should be paid attention to.