2型糖尿病患者血清甲状腺激素及抗体表达水平与糖尿病周围神经病变的关系

Relationship between serum thyroid hormone and antibody expression and diabetic peripheral neuropathy in patients with type 2 diabetes mellitus

目的:探讨甲状腺激素、抗体在2型糖尿病中的表达及其与患者糖尿病周围神经病变的关系。方法:将2型糖尿病合并糖尿病周围神经病变的106例患者作为B组;将无合并糖尿病周围神经病变的118例患者作为A组。比较两组一般资料、甲状腺激素水平、抗体表达水平,用Logistic回归分析法分析2型糖尿病患者合并糖尿病周围神经病变的危险因素。结果:与A组相比,B组年龄较大,2型糖尿病病程更长(P<0.05);外周血抗甲状腺球蛋白抗体(TG-Ab)、抗甲状腺过氧化物酶抗体(TPO-Ab)、血清促甲状腺激素(TSH)、空腹胰岛素(FINS)水平、HOMA-IR指数更高(P<0.05);外周血TR-Ab水平更低(P<0.05)。Logistic回归分析结果显示,影响2型糖尿病患者合并糖尿病周围神经病变的危险因素为2型糖尿病病程较长、HOMA-IR指数、外周血TPO-Ab、血清FINS、TSH水平较高(OR=1.468、1.372、1.338、1.435、1.344),差异均具有统计学意义(P<0.05)。结论:2型糖尿病病程长、血糖情况、血清甲状腺激素及抗体表达水平异常的2型糖尿病患者,其合并糖尿病周围神经病变的几率更高,对于2型糖尿病合并糖尿病周围神经病变的患者,其甲状腺功能状况在评价其病情和预后方面有重要意义。

Objective:To investigate the expression of thyroid hormone and antibody in type 2 diabetes mellitus and their relationship with diabetic peripheral neuropathy.Methods:106 patients with type 2 diabetes combined with diabetes peripheral neuropathy were retrospectively included as group B,and 118 patients without diabetes peripheral neuropathy were included as group A.The general data,thyroid hormone level and antibody expression level of the two groups were compared,and the risk factors of type 2 diabetic patients complicated with diabetic peripheral neuropathy were analyzed by Logistic regression analysis.Results:Compared with group A,group B was older,and the course of type 2 diabetes was relatively longer,with statistical differences(P<0.05).Peripheral blood anti thyroglobulin antibody(TG-Ab),anti thyroid peroxidase antibody(TPO-Ab),serum thyroid stimulating hormone(TSH),fasting insulin(FINS)levels,and HOMA-IR index were higher,with statistical differences(P<0.05),while peripheral blood TR-Ab was lower,with statistical differences(P<0.05).Logistic regression analysis showed that the risk factors affecting diabetic peripheral neuropathy in patients with type 2 diabetes mellitus were longer course of disease,higher HOMA-IR value,higher levels of TPO-Ab in peripheral blood,and higher levels of FINS and TSH in serum(OR were 1.468,1.372,1.338,1.435 and 1.344,respectively),which were statistically significant(P<0.05).Conclusion:Type 2 diabetes patients with long course of disease,abnormal levels of blood glucose,serum thyroid hormone and antibody expression are more likely to have diabetic peripheral neuropathy.For type 2 diabetes patients with diabetic peripheral neuropathy,thyroid function is of great significance in evaluating the disease and prognosis.