2型糖尿病患者高促甲状腺激素水平与胰岛素抵抗、氧化应激的关系  

Relationship between type 2 diabetic patients with high thyroid stimulating hormone level and insulin resistance and oxidative stress

作　　者：孟祥凤[1] 刘海霞[1] 王学慧[1] 李庆美[2] 张奕[1] 刘长山[1] 

机构地区：[1]山东省潍坊市人民医院,山东潍坊261041 [2]山东省潍坊市妇幼保健院,山东潍坊261011

出　　处：《中国现代医学杂志》2015年第8期39-42,共4页China Journal of Modern Medicine

摘　　要：目的通过8-异前列腺素F2α（8-iso-PGF2α）探讨2型糖尿病患者高促甲状腺激素（TSH）水平与胰岛素抵抗（IR）及氧化应激（OS）的关系。方法选取124例住院治疗的2型糖尿病高TSH水平患者为研究组,选取124例同期住院治疗的2型糖尿病正常TSH水平患者为对照组。于入院第2天上午7：00~9：00空腹测量身高、体重、血压,计算体重指数（BMI）;空腹采静脉血检测甲状腺功能、血糖、胰岛素、糖化血红蛋白（HbA1c）和8-iso-PGF2α。结果两组年龄、收缩压（SBP）、舒张压（DBP）、病程、Hb A1c比较,差异无统计学意义（P〉0.05）。研究组BMI（P=0.014）、8-iso-PGF2α（P〈0.001）、胰岛素抵抗指数（HOMA-IR）（P〈0.001）明显高于对照组。以Ln TSH为因变量的多元逐步回归分析显示,8-iso-PGF2α是影响高TSH水平的主要因素（P〈0.001）,HOMA-IR为次要因素（P=0.015）。结论 2型糖尿病患者高TSH水平与IR及OS有关,可作为2型糖尿病合并甲状腺功能减退症或亚临床甲状腺功能减退症抗氧化治疗的理论依据。[Objective] To explore the the relationship between type 2 diabetic patients with high thyroid stimulating hormone （TSH） level and insulin resistance and oxidative stress through 8-iso prostaglandin F2α （8-iso-PGF2α）. [Methods] A total of 124 cases of type 2 diabetic inpatients with high TSH were selected as the study group, and 124 cases of type 2 diabetic inpatients with normal TSH were selected as the control group. From 7：00 to 9：00 in the morning of the second day, fasting height, weight and blood pressure were measured, and the body mass index （BMI） was calculated in both groups. Meanwhile fasting venous blood was collected to detect thyroid function, blood glucose, insulin, HbAlc and 8-iso prostaglandin F2α. [Results] There were no significant differences between the two groups in age, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, course of disease and HbAlc （P〉0.05）. BMI （P= 0.014）, 8-iso-PGF2α （P〈0.001） and homeostasis model assessment of insulin resistance （HOMA-IR, P〈 0.001） in the high TSH level group were significantly higher than those in the normal TSH level group. The dependent variable with LnTSH in the multivariate stepwise regression analysis showed that 8-iso-PGF2α was the main factor affecting the high level of TSH （P〈0.001） and HOMA-IR was the secondary factor （P=0.015）. [Conclusion] High TSH level of type 2 diabetic patients is related to insulin resistance and oxidative stress. The research can provide a theoreticalbasis for antioxidant therapy for type 2 diabetes mellitus complicated with hypothyroidism and subclinical hy- pothyroidism.

关 键 词：2型糖尿病 高促甲状腺激素水平 胰岛素抵抗 氧化应激 

分 类 号：R587.1[医药卫生—内分泌]