2型糖尿病患者甲状腺激素水平与肥胖相关指标的关系

Relationship between thyroid hormone level and obesity related indices in patients with type 2 diabetes mellitus

目的探讨2型糖尿病患者正常范围内的血清甲状腺激素水平与体质量、血糖、血脂等肥胖相关指标的关系。方法选取黑龙江省医院南岗分院2020年5月至2021年5月住院治疗的肥胖2型糖尿病患者70例和体质量正常2型糖尿病患者92例为研究对象,所有受试者的促甲状腺激素水平均在正常范围内(0.35~4.94 mU/L)。测定血清游离三碘甲状腺原氨酸、血清游离甲状腺素、促甲状腺激素、甲状腺过氧化物酶抗体、甲状腺球蛋白抗体、三酰甘油、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、空腹血糖、糖化血红蛋白、空腹C肽、空腹胰岛素、收缩压、舒张压和血尿酸,并进行分析。结果血清游离三碘甲状腺原氨酸与空腹血糖、糖化血红蛋白呈正相关(r=0.19,P=0.021;r=0.21,P=0.017);血清游离甲状腺素与糖化血红蛋白呈正相关(r=0.25,P=0.009),与总胆固醇呈负相关(r=-0.17,P=0.029),血清促甲状腺激素与体质量指数、总胆固醇、低密度脂蛋白胆固醇呈正相关(r=0.33,P<0.001;r=0.33,P<0.001;r=0.32,P<0.001)。结论正常范围内的甲状腺激素在2型糖尿病患者体质量、血糖及血脂的调节中起到重要作用,血清游离三碘甲状腺原氨酸和血清游离甲状腺素相对较高者血糖升高明显,血清促甲状腺激素相对较高者肥胖及血脂紊乱的风险增高。

Objective To investigate the relationship between serum thyroid hormone levels in the normal range and body weight,blood glucose,blood lipids,and other obesity-related indexes in patients with type 2 diabetes mellitus.Methods Seventy obese patients with type 2 diabetes mellitus and ninety-two patients with type 2 diabetes mellitus with normal weight who were treated in the Nangang Branch of Heilongjiang Provincial Hospital from May 2020 to May 2021 were included in this study.Thyroid-stimulating hormone level was in the normal range(0.35-4.94 mU/L)in all participants.Serum levels of free triiodothyronine,free thyroxine,thyroid-stimulating hormone,thyroid peroxidase antibody,thyroglobulin antibody,triglyceride,total cholesterol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,fasting blood glucose,glycosylated hemoglobin,fasting C peptide,fasting insulin,systolic blood pressure,diastolic blood pressure,and serum uric acid were measured in all participants.Results Free triiodothyronine level was positively correlated with fasting blood glucose and glycosylated hemoglobin levels(r=0.19,P=0.021;r=0.21,P=0.017).Free thyroxine level was positively correlated with serum glycosylated hemoglobin level(r=0.25,P=0.009)and negatively correlated with total cholesterol(r=-0.17,P=0.029).Thyroid-stimulating hormone level was positively correlated with body mass index as well as total cholesterol and low-density lipoprotein cholesterol levels(r=0.33,P<0.001;r=0.33,P<0.001;r=0.32,P<0.001).Conclusion Thyroid hormones in the normal range play an important role in the regulation of body weight,blood glucose,and blood lipids in patients with type 2 diabetes mellitus.Blood glucose level increases markedly in patients with relatively high free triiodothyronine and free thyroxine levels.The risks of obesity and dyslipidemia increase in patients with relatively high serum thyroid-stimulating hormone levels.