甲状腺功能正常的老年2型糖尿病患者TSH水平与颈动脉内膜中膜厚度的相关性研究

Relationship between TSH level and carotid intima-media thickness in elderly type 2 diabetes mellitus patients with normal thyroid function

目的探讨甲状腺功能正常的老年2型糖尿病(T2DM)患者促甲状腺激素(TSH)水平与颈动脉内膜中膜厚度(CIMT)的关系。方法选取2020年5月—2024年3月上海市同仁医院内分泌科门诊及住院诊疗的617例甲状腺功能正常的老年T2DM患者,以CIMT 1.0 mm为切点分为CIMT正常组(CIMT<1.0 mm)和CIMT增厚组(CIMT≥1.0 mm),收集患者资料进行横断面分析。结果CIMT增厚组年龄、收缩压、空腹C肽、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)、TSH、饮酒比例高于CIMT正常组(P<0.05)。年龄(OR=1.074,95%CI:1.0221.128,P=0.005)、空腹C肽(OR=2.048,95%CI:1.0324.061,P=0.040)、LDL-C(OR=1.959,95%CI:1.1793.257,P=0.009)、TSH(OR=1.456,95%CI:1.1601.826,P=0.001)、饮酒(OR=0.504,95%CI:0.2830.897,P=0.020)为CIMT增厚的独立危险因素。结论正常范围内较高水平的血清TSH是甲状腺功能正常的老年T2DM患者CIMT增厚的独立危险因素。

Objective To explore the relationship between thyroid stimulating hormone(TSH)level and carotid intima-media thickness(CIMT)in elderly type 2 diabetes mellitus(T2DM)patients with normal thyroid function.Methods A total of 617 elderly T2DM patients with normal thyroid function from outpatient and inpatient treated in Department of Endocrinology of Shanghai Tongren Hospital from May 2020 to March 2024 were selected.With CIMT 1.0 mm as the cut-off point,they were divided into CIMT normal group(CIMT<1.0 mm)and CIMT thickening group(CIMT≥1.0 mm).Their clinical data were collected for cross-sectional analysis.Results The age,systolic blood pressure,fasting C-peptide,total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C),uric acid(UA),TSH,and the proportion of alcohol consumption in the CIMT thickening group were higher than those in the CIMT normal group(P<0.05).Age(OR=1.074,95%CI:1.022-1.128,P=0.005),fasting C-peptide(OR=2.048,95%CI:1.032-4.061,P=0.040),LDL-C(OR=1.959,95%CI:1.179-3.257,P=0.009),TSH(OR=1.456,95%CI:1.160-1.826,P=0.001)and alcohol consumption(OR=0.504,95%CI:0.283-0.897,P=0.020)were independent risk factors for CIMT thickening.Conclusion A higher level of serum TSH within the normal range is an independent risk factor for CIMT thickening in elderly T2DM patients with normal thyroid function.