血清FPG、2hPG及血压水平与脂代谢异常患者发生甲状腺功能减退症的相关性分析

Correlation between Serum FPG,2hPG,Blood Pressure and Hypothyroidism in People with Abnormal Lipid Metabolism

【目的】探讨血清空腹血糖(FPG)、餐后2 h血糖(2hPG)及血压水平与脂代谢异常患者发生甲状腺功能减退症(简称甲减)的相关性。【方法】选取2020年3月至2022年3月本院收治的86例脂代谢异常患者,根据《成人甲状腺功能减退症诊治指南》中的诊断标准将86例患者分为亚临床甲状腺功能减退(SCH)组[促甲状腺激素(TSH)>4.5 mIU/L,n=38]和非减退组(TSH≤4.5 mIU/L,n=48);并依据美国内分泌协会2004年对SCH的诊断标准,将SCH组分为轻度甲减组(n=25)和重度甲减组(n=13)。比较各组血清FPG、2hPG、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及舒张压(DBP)、收缩压(SBP);采用受试者工作特征(ROC)曲线分析血清FPG、2hPG及血压对脂代谢异常患者发生甲减的预测价值;采用Pearson系数分析血清FPG、2hPG及血压水平与脂代谢异常患者TSH水平的相关性。【结果】SCH组FPG、2hPG、DBP、SBP、TG、TC、LDL-C水平均高于非减退组,HDL-C水平低于非减退组,差异有统计学意义(P<0.05)。轻度甲减组FPG、2hPG、DBP、SBP、TG、TC、LDL-C水平均低于重度甲减组,HDL-C水平高于重度甲减组,差异有统计学意义(P<0.05)。ROC曲线分析结果显示:血清FPG、2hPG、DBP、SBP预测脂代谢异常者发生甲减的最佳截断值分别为5.243 mmol/L、7.014 mmol/L、80.050 mmHg、128.450 mmHg。相关性分析结果显示:FPG、2hPG、DBP、SBP水平与脂代谢异常患者TSH水平均呈正相关(P<0.05)。【结论】甲减和未发生甲减的脂代谢异常患者血清FPG、2hPG、血压及脂代谢指标水平存在显著差异,FPG、2hPG、DBP、SBP水平与脂质代谢异常患者TSH水平呈显著正相关。

【Objective】To analyze the correlation between serum fasting glucose(FPG),2 h postprandial glucose(2hPG)and blood pressure levels and hypothyroidism in people with abnormal lipid metabolism.【Methods】A total of 86 patients with abnormal lipid metabolism admitted to our hospital from March 2020 to March 2022 were selected.According to the Guidelines for the Diagnosis and Treatment of Adult Hypothyroidism,86 patients were divided into subclinical hypothyroidism(SCH)group(TSH>4.5 mIU/L,n=38)and non hypothyroidism group(TSH≤4.5 mIU/L,n=48).According to the diagnostic criteria of American Endocrine Association for SCH in 2004,the SCH group was divided into mild hypothyroidism group(n=25)and severe hypothyroidism group(n=13).Serum FPG,2hPG,total cholesterol(TC),triglyceride(TG),low-density lipoprotein(LDL-C),high-density lipoprotein(HDL-C),diastolic blood pressure(DBP)and systolic blood pressure(SBP)were measured in all subjects.The levels of FPG,2hPG,DBP,SBP,TC,TG,LDL-C and HDL-C in patients with hypothyroidism of different degrees were compared between the two groups;The value of ROC analysis of serum FPG,2hPG and blood pressure in predicting hypothyroidism in patients with abnormal lipid metabolism;The correlation between serum FPG,2hPG,blood pressure and TSH level in patients with abnormal lipid metabolism was analyzed by Person coefficient.【Results】The levels of FPG,2hPG,DBP,SBP,TG,TC,LDL-C in the SCH group were higher than those in the non decreased group,and the HDL-C levels were lower than those in the non decreased group,with a statistically significant difference(P<0.05).The levels of FPG,2hPG,DBP,SBP,TG,TC and LDL-C in mild hypothyroidism group were lower than those in severe hypothyroidism group,and the levels of HDL-C were higher than those in severe hypothyroidism group,with statistical significance(P<0.05).According to ROC analysis,the best cutoff values of serum FPG,2hPG and DBP,SBP levels for predicting hypothyroidism in patients with abnormal lipid metabolism were 5.243 mmol/L,7.014 mmol/L,80.050 mmHg,128.450 mmHg.Through correlation analysis,the levels of FPG,2hPG,DBP,SBP were positively correlated with the levels of TSH in patients with abnormal lipid metabolism(P<0.05).【Conclusion】The levels of serum FPG,2hPG,blood pressure and lipid metabolism indexes were significantly different between those with abnormal lipid metabolism who had hypothyroidism and those without hypothyroidism.The levels of FPG,2hPG,DBP and SBP were significantly positively correlated with the levels of TSH in those with abnormal lipid metabolism.