亚临床甲状腺功能减退症患者及甲状腺功能正常者甲状腺功能与血糖水平的关系  

Relationship between thyroid function and glucose level in adults with subclinical hypothyroidism and euthyroid

作　　者：朱雨霏[1] 赖亚新[1] 姜凤伟[1] 王蓓蓓[1] 贡呜[1] 张乐[1] 孙华坤[1] 单忠艳[1] 滕卫平[1] 

机构地区：[1]中国医科大学附属第一医院内分泌科辽宁省内分泌疾病重点实验室,沈阳110001

出　　处：《中华糖尿病杂志》2012年第3期139-143,共5页CHINESE JOURNAL OF DIABETES MELLITUS

摘　　要：目的研究亚临床甲状腺功能减退症患者及甲状腺功能正常者甲状腺功能与血糖的关系。方法采用整群抽样法于2007年至2010年从沈阳市城市成年居民中招募2751名研究对象，行问卷调查，测量血压、身高、体重、腰围、促甲状腺激素、游离三碘甲状腺原氨酸、游离甲状腺素、空腹血糖、口服葡萄糖耐量试验2h血糖、甘油三酯、总胆固醇和高密度脂蛋白胆固醇。将受试者分为亚临床甲状腺功能减退症组（n=193）及甲状腺功能正常组（n=2146），甲状腺功能正常组又进一步分为促甲状腺激素低水平组（n=352，促甲状腺激素／〉0．3-〈1．0mU／L）、促甲状腺激素中水平组（n=916，促甲状腺激素≥1．0-≤1．9mU／L）、促甲状腺激素高水平组（n=944，促甲状腺激素1．9〈-≤4．8mU／L）。受试者根据血糖水平进一步分为糖耐量正常组、糖调节异常组、糖尿病组，分析甲状腺功能指标与血糖的关系。采用t检验及方差分析进行数据统计。结果亚临床甲状腺功能减退症组口服葡萄糖耐量试验2h血糖明显高于甲状腺功能正常组[（8．34-4．4）vs（7．74-4．2）mmol／L，t=一2．163，P〈0．05]，2组糖调节异常及糖尿病的患病率差异无统计学意义。糖尿病组游离甲状腺素水平高于糖调节异常组和糖耐量正常组[分别为（16．8±2．1）、（16．3±2．1）、（16．2±1．9μmol／L，F=10．515，P〈0．01]，女性中糖尿病组[15．3％（26／188）]及糖调节异常组[15．0％（34／227）]亚临床甲状腺功能减退症的患病率明显高于糖耐量正常组[9．5％（86／903）]（）（2值分别为7．165、5．685，均P〈0．05），女性亚临床甲状腺功能减退症的患病率明显高于男性[11．1％（146／1318）VS4．6％（47／1027），x2=31．852，P〈0．01]。多元线性回归分析显示，校正体质指数、腰围、血压、血脂后，总体受试者空腹血糖Objective To investigate the relationship between thyroid function and glucose level in adults with subclinical hypothyroidism and euthyroid. Methods A total of 2751 subjects completed a questionnaire survey and measurement for blood pressure, height, body weight, waist circumference, thyroidstimulating hormone （ TSH ） , free triiodothyronine （ FTa ）, fl＇ee thyroxine （ ft4 ） , fasting plasma glucose （FPG）, oral glucose tolerance test （OGTF） 2-h glucose, triglyceride （TG）, total cholesterol （TC） and high-density lipoprotein cholesterol （HDL-C）. According to the level of thyroid hormone, the subjects weredivided into subclinical hypothyroidism group （ n = 193 ） and euthyroid group （ n = 2146 ）. Those in theeuthyroid group were further divided into low TSH group （ n = 352, TSH 〉0. 3 to 〈 1.0 mU/L）, moderate TSHgroup （n=916, TSH I〉1.0 to ≤1.9 mU/L） and highTSH group （n=944, TSH 1.9〈 to ≤4.8 mU/L）. According to serum level of glucose, all the subjects were divided into normal glucose tolerance （NGT） group, impaired glucose regulation （IGR） group, and diabetes mellitus （DM） group. The relationship between thyroid function indexes and glucose was analyzed. Student＇ s t test or Analysis of Variance was used for data analysis. Results The level of OGTF 2-h glucose in the subclinical hypothyroidism group was significantly higher than that in the euthyroid group （ （ 8. 3 ± 4.4 ） vs （ 7.7 ± 4. 2 ）mmol/L, t = -2. 163, P 〈0. 05）. The level of FT4 in the DM group was significantly higher than that in the 1GR group and NGT group （ （ 16.8 ± 2. 1 ）, （ 16. 3 ± 2. 1 ）, and （ 16. 2 ± 1.9 ） pmol/L, respectively; F = 10. 515, P 〈0. 01 ）. The prevalence of subclinical hypothyroidism in the DM group and IGR group was significantly higher than that in the NGT group in females, and the prevalence of subclinical hypothyroidism in females was significantly higher than that in males. After adjusting for body mass index （BMI�

关 键 词：亚临床甲状腺功能减退症 甲状腺功能 血糖 

分 类 号：R581.2[医药卫生—内分泌]