2型糖尿病患者血清甲状腺激素检测的临床意义  

Analysis of serum thyroid hormone levels in type 2 diabetic patients and its relationship with HbA 1c,C-peptide

作　　者：周静[1] 张士荣[1] 严鸣[1] 刘丽利[1] 

机构地区：[1]安徽省蚌埠医学院第一附属医院内分泌科,233004

出　　处：《中华全科医学》2014年第12期1990-1992,共3页Chinese Journal of General Practice

摘　　要：目的探讨2型糖尿病患者血清甲状腺激素的变化情况及其与糖化血红蛋白、C肽的相关性。方法将84例2型糖尿病患者按空腹血糖值(FBG)分为3组:A组轻度增高组(6.10 mmol/L≤FBG<8.0 mmol/L)、B组中度增高组(8.0 mmol/L≤FBG<12.0 mmol/L)、C组重度增高组(FBG≥12.0 mmol/L),测定3组2型糖尿病患者和36名健康对照组血清甲状腺激素(FT3、T3、FT4、T4、TSH)、C肽、糖化血红蛋白(HbA1c)水平,观察2型糖尿病患者各分组中甲状腺激素水平变化特点,并分析其与HbA1c、C肽相关性。结果 2型糖尿病患者血清游离甲状腺原氨酸和甲状腺原氨酸(FT3、T3)水平明显低于对照组(F值分别为51.101、31.193,P<0.01),而其他甲状腺激素(FT4、T4、TSH)水平与对照组差异无统计学意义(P>0.05)。3组2型糖尿病患者分组比较,C组FT3、T3水平较A组显著降低(P<0.01),其他甲状腺激素与另两组相比差异无统计学意义(P>0.05)。FT3与HbA1c呈负相关(r=-0.422,P<0.01),与C肽呈正相关(r=0.378,P<0.05)。结论 2型糖尿病患者随空腹血糖升高,血清FT3、T3水平呈下降趋势,测定甲状腺激素可反映患者糖代谢紊乱的程度。Objective To investigate the changes in thyroid hormone levels in type 2 diabetic patients and its correlation with glycated hemoglobin, C-peptide. Methods By fasting glucose values, the 84 cases of type 2 diabetes were divided into three groups. A group ： slightly increased group （ 6.10 mmol/L~〈 FBG 〈 8.0 mmol/L） ; B group： moderately increased group（8.0 mmol/L〈~ FBG 〈 12.0 mmol/L） ; C group： severe increased group （ FBG〉~ 12.0 mmoL/L）. The serum was collected from three groups of diabetic patients and 36 healthy control group. The levels of serum thyroid hormones T3, T4, T3, T4, TSH, HbAlc, C peptide were measured. Then the changes of thyroid hormones were observed in each group of type 2 diabetic mellitus patients. And the correlation between thyroid hormones and HbAlc,C peptide were analyzed. Results The levels of serum T3, FT3 in type 2 diabetes mellitus patients were significantly lower than those in the con- trol group （ FT3 ：F = 51. 101 and P 〈 0.01 ;T3 ：F = 31. 193 and P 〈 0.01 ）, while the levels of serum T4, T4, TSH in type 2 diabetes mellitus patients were no statistically significant difference with those in the control group（ P 〉 0.05 ）. The lev- els of serum T3 ,FI3 in C group were significantly lower than those in group A（P 〈0.01 ） ,while the levels of serum FT4, T4, TSH showed no significant difference with those in group A and group B （ P 〉 0.05 ）. FT3 was negatively related with HbA1 c （ r = - 0. 422, P 〈 0.01 ） and positively correlated with C-peptide （ r = 0. 378, P 〈 0.05 ）, and the other thyroid hormones and HbA1 c, C peptide had no correlation. Conclusion With the fasting blood sugar, serum FT3, T3 levels in type 2 diabetic patients were decreased, and thyroid hormones level in T2DM patients can reflect the degree of glucose me- tabolism disorder.

关 键 词：2型糖尿病 甲状腺激素 糖化血红蛋白(HbA1c) C肽(C-P) 

分 类 号：R587.1[医药卫生—内分泌] R446.11[医药卫生—内科学]