老年2型糖尿病患者血清维生素D与甲状腺功能指标的关联分析

Correlation between serum vitamin D and thyroid function indicators among elderly patients with type 2 diabetes mellitus

目的探究老年2型糖尿病(T2DM)患者血清维生素D水平与甲状腺功能指标的关系,为防治老年T2DM患者甲状腺功能异常提供依据。方法选择浙江医院内分泌科住院治疗的≥60岁T2DM患者为研究对象,采用问卷调查收集性别、年龄和病程等基本资料,采血检测血清25-羟维生素D[25-(OH)D]、促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、总三碘甲状腺原氨酸(TT3)和总甲状腺素(TT4)等指标。采用多重线性回归模型分析老年T2DM患者25-(OH)D与甲状腺功能指标的关联。结果调查老年T2DM患者402例,其中男性210例,占52.24%;女性192例,占47.76%。年龄M(QR)为70.00(12.00)岁。T2DM病程M(QR)为14.00(14.00)年。维生素D不足162例,占40.30%;缺乏182例,占45.27%。维生素D缺乏组T2DM患者的TSH和糖化血红蛋白分别为(2.34±1.66)μIU/mL和(8.83±2.14)%,高于维生素D正常组的(1.74±1.10)μIU/mL和(8.11±1.75)%;维生素D缺乏组T2DM患者的FT3和FT3/FT4分别为(2.86±0.48)pg/mL和2.85±0.71,低于维生素D不足组的(3.09±0.47)pg/mL和3.14±0.81(均P<0.05)。多重线性回归分析结果显示,25-(OH)D与TSH(β'=-0.159,P=0.001)呈负相关。结论老年T2DM患者TSH水平升高可能与维生素D缺乏有关。

Objective To examine the association between serum vitamin D level and thyroid function indicators among elderly patients with type 2 diabetes mellitus(T2DM),so as to provide the evidence for the prevention and treatment of thyroid function abnormality among elderly patients with T2DM.Methods Inpatients aged 60 years and older and admitted to the department of endocrinology of Zhejiang Hospital were selected as the study subjects.Gender,age,course of disease and other basic information were collected through questionnaire surveys.The serum 25-hydroxyvitamin D[25-(OH)D],thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroxine(FT4),total triiodothyronine(TT3),and total thyroxine(TT4)were measured.The correlation between serum vitamin D level and thyroid function indicators in elderly patients with T2DM was evaluated by a multiple linear regression model.Results A total of 402 elderly patients with T2DM were surveyed,including 210 males(52.24%)and 192 females(47.76%),and had a median age of 70.00(interquartile range,12.00)years and a median course of disease of 14.00(interquartile range,14.00)years.There were 162 patients with insufficiency of vitamin D(40.30%)and 182 patients with deficiency(45.27%).The levels of TSH and glycated hemoglobin in the vitamin D deficiency group were(2.34±1.66)μIU/mL and(8.83±2.14)%,respectively,which were higher than those in the normal group[(1.74±1.10)μIU/mL and(8.11±1.75)%;P<0.05].The levels of FT3 and FT3/FT4 in the vitamin D deficiency group were(2.86±0.48)μIU/mL and 2.85±0.71,respectively,which were lower than those in the vitamin D insufficiency group[(3.09±0.47)pg/mL and 3.14±0.81,P<0.05].Multiple linear regression analysis showed a negative correlation between 25-(OH)D and TSH(β'=-0.159,P=0.001).Conclusion The vitamin D deficiency may be associated with the increase of TSH level among the elderly patients with T2DM.