2型糖尿病老年患者甲状腺激素水平与胰岛素抵抗的相关性分析

Correlation Analysis of Thyroid Hormone Levels and Insulin Resistance in Elderly Patients with Type 2 Diabetes Mellitus

目的分析甲状腺激素水平与胰岛素抵抗相关性,为2型糖尿病老年患者的诊治提供依据。方法选取2021年5月—2023年5月淄博市张店区人民医院收治的100例2型糖尿病老年患者为研究对象(A组),按照胰岛素抵抗程度分为一般胰岛素抵抗组(n=33)、严重胰岛素抵抗组(n=33)、极度胰岛素抵抗组(n=34)。选取同期健康查体中心102例健康人群为对照组(B组)。比较A、B两组患者及A组中3个亚组间的甲状腺激素水平、胰岛素抵抗指标,分析甲状腺激素水平与胰岛素抵抗严重程度的相关性。结果A组游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、游离甲状腺素(free thyroxine,T4)、胰岛素抵抗指数(homeostasis model assessment for insulin resistance,HOMA-IR)均高于B组,促甲状腺激素(thyroid stimulating hormone,TSH)低于B组,差异有统计学意义(P均<0.05)。A组中3个亚组间的FT3、FT4、TSH比较,差异有统计学意义(P均<0.05)。FT3、FT4与胰岛素抵抗严重程度呈正相关,TSH与胰岛素抵抗严重程度呈负相关。结论甲状腺激素水平与胰岛素抵抗之间存在明显的相关性。

Objective To analyze the correlation between thyroid hormone levels and insulin resistance,and to provide a basis for the diagnosis and treatment of elderly patients with type 2 diabetes mellitus.Methods A total of 100 elderly patients with type 2 diabetes mellitu admitted to Zhangdian District People's Hospital from May 2021 to May 2023 were selected as the study subjects(group A).According to the degree of insulin resistance,they were divided into general insulin resistance group(n=33),severe insulin resistance group(n=33)and extreme insulin resistance group(n=34).At the same time,102 healthy people in the health examination center were selected as the control group(group B).The thyroid hormone levels and insulin resistance indexes of patients in group A and group B and three subgroups in group A were compared,and the correlation between thyroid hormone levels and the severity of insulin resistance was analyzed.Results Free triiodothyronine(FT3),free thyroxine(FT4)and homeostasis model assessment for insulin resistance(HOMA-IR)in group A were higher than those in group B,and thyroid stimulating hormone(TSH)was lower than that in group B,and the differences were statistically significant(all P<0.05).There were statistically significant differences in FT3,FT4 and TSH among the three subgroups of group A(all P<0.05).FT3 and FT4 were positively correlated with the severity of insulin resistance,TSH was negatively correlated with the severity of insulin resistance.Conclusion There is a significant correlation between thyroid hormone levels and insulin resistance.