甲状腺功能正常的初诊2型糖尿病患者血总胆红素与甲状腺激素水平的相关性

Correlations between total bilirubin and thyroxine among euthyroid patients with newly diagnosed type 2 diabetes mellitus

目的探讨甲状腺功能正常的初诊2型糖尿病(T2DM)患者血清甲状腺激素与总胆红素(TBIL)的相关性。方法选取280例初诊甲状腺功能正常的T2DM患者为T2DM组,选取276例健康人为对照(NC)组,分析各组甲状腺激素水平与TBIL的相关性。结果 T2DM组血清游离T3(FT3)水平与TBIL呈正相关(r=0. 512,P <0. 01),游离T4(FT4)及促甲状腺激素(s TSH)与TBIL无明显相关性;NC组以上指标之间均无明显相关性。多元线性回归分析显示:在T2DM患者中,FT3与TBIL的相关性受Hb A1c调控(β=0. 244,P=0. 02),在排除年龄、性别、血脂、丙氨酸转氨酶、乙醇摄入、BMI、空腹胰岛素影响后,这种调控作用依然存在。结论低FT3与甲状腺功能正常的初诊T2DM患者低TBIL水平相关,此相关性受Hb A1c调控;Hb A1c越高,相关性越显著。这可能是高Hb A1c的初诊T2DM患者容易发生动脉粥样硬化(AS)的原因之一。

Objective To investigate the correlations between total bilirubin and thyroxine among euthyroid patients with newly diagnosed type 2 diabetes mellitus.Methods A total of 280 newly diagnosed patients with type 2 diabetes mellitus and another276 healthy people were selected.The correlations between thyroxine and total bilirubin were analyzed.Results Bilirubin was positively correlated with free T3 in 280 T2 DM subjects(r=0.512,P<0.01),but free thyroid and thyroid-stimulating hormone were not.Such correlations were not found in 276 non-diabetic subjects(r=0.086,P>0.05).During multiple linear regression analysis,free T3 was found to interact positively with the presence of Hb A1 c on serum bilirubin(interaction term:β=0.244,P=0.01).This interaction remained present after additional adjustment for alcohol intake,aspartate transaminase,insulin sensitivity,cholesterol,triglycerides,BMI and fasting insulin.Conclusions Low bilirubin is related to low free T3 levels in euthyroid and newly diagnosed diabetic subjects,The relationship can be modified by Hb A1 c.It is the possible mechanism of high atherosclerosis in newly diagnosed patients type 2 diabetes with high HbA1c.