亚临床甲状腺功能减退与2型糖尿病慢性并发症的关系  

Association of subclinical hypothyroidism with diabetic chronic complications in type 2 diabetic patients

作　　者：张冬梅[1] 张莉[1] 郑莹莹[1] 曾怡[1] 廖岚[1] 雷闽湘[1] 

机构地区：[1]中南大学湘雅医院内分泌科,长沙410008

出　　处：《中国糖尿病杂志》2014年第1期25-29,共5页Chinese Journal of Diabetes

摘　　要：目的探讨亚临床甲状腺功能减退(SCH)与T2DM慢性并发症的关系。方法将1294例T2DM患者分为SCH组和甲状腺功能正常组,比较两组间慢性并发症患病率及患者的甲状腺功能,采用Logistic多元回归分析SCH与T2DM慢性并发症的关系。结果 18.8%的T2DM患者合并SCH。SCH组糖尿病慢性肾脏疾病(CKD)、DR、糖尿病周围神经病变(DPN)和糖尿病足(DF)患病率均高于甲状腺功能正常组(P<0.05)。CKD、DR和DPN患者FT3下降,促甲状腺激素(TSH)升高(P<0.05)。Logistic多元回归分析显示,SCH为CKD的独立危险因素(OR=3.39,P=0.012)。结论 T2DM合并SCH患者CKD、DR、DPN和DF患病率升高。SCH是CKD的独立危险因素。Objective To investigate the clinical characteristics of T2DM patients with subclinical hypothyroidism （SCH）, and explore the relationship between SCH and diabetic chronic complications. Methods Clinical characteristics and prevalence of diabetic chronic complications, including chronic kidney disease （CKD）, diabetic retinopathy （DR）, diabetic peripheral neuropathy （DPN） and diabetic foot （DF）, were compared between patients with euthyroid versus subclinical hypothyroidism. Thyroid function was also studied in patients with chronic complications. Logistic regression models were used to estimate association of subclinical hypothyroidism with diabetic complications. Results The prevalence of subclinical hypothyroidism in T2DM inpatients was 18.8%. Compared with euthyroid diabetic patients, patients with subclinical hypothyroidism had a higher proportion of CKD, DR, DPN and DF （P〈0.05）. Diabetic patients with CKD, DR and DPN had decreased FT3 and increased TSH levels （P〈0.05）. Logistic regression analysis showed that subclinical hypothyroidism was an independent risk factor for CKD, DR and DPN. for CKD （OR=3.39,P=0.012）. Conclusion T2DM patients with SCH have a higher proportion of CKD, DR, DPN and DF. SCH is independently associated with CKD in T2DM.

关 键 词：糖尿病 2型 糖尿病慢性并发症 亚临床甲状腺功能减退 糖尿病大血管病变 

分 类 号：R587.1[医药卫生—内分泌]