2型糖尿病合并非酒精性脂肪性肝病患者促甲状腺激素水平变化及其相关性分析  

Level Variation and Relative Analysis of Serum TSH on NAFLD with Type 2 Diabetes Mellitus

作　　者：刘滨菘[1] 李强[1] 崔璨[1] 高萍[1] 宋海燕[1] 张巾超[1] 

机构地区：[1]哈尔滨医科大学附属第二医院内分泌与代谢病科,哈尔滨150086

出　　处：《临床误诊误治》2016年第7期91-94,共4页Clinical Misdiagnosis & Mistherapy

基　　金：中国博士后科学基金(20110491109)

摘　　要：目的观察2型糖尿病合并非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)患者促甲状腺激素(TSH)水平及其相关性。方法选取92例2型糖尿病患者作为研究对象,根据是否合并NAFLD分为NAFLD组(F组)60例和无NAFLD组(NF组)32例。比较两组体重、体重指数(BMI)等一般资料及肝肾功能、甲状腺功能等指标,分析F组TSH与余上述指标的相关性,并采用logistic回归分析找出NAFLD的独立危险因素。结果与NF组比较,F组体重及BMI均显著升高(P<0.01),F组γ-谷氨酰转肽酶(GGT)、甘油三酯(TG)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)及TSH值均大于NF组,高密度脂蛋白胆固醇(HDL-C)小于NF组,差异均有统计学意义(P<0.05或P<0.01)。TSH与BMI、GGT、TG、FPG、FINS及HOMA-IR呈正相关;logistic回归分析显示,BMI、TG、HOMA-IR、TSH是NAFLD的独立危险因素。结论 2型糖尿病合并NAFLD患者TSH水平升高,其水平与肝脏糖、脂代谢密切相关,可能成为预测NAFLD的独立危险因素。Objective To observe the levels variation and relative analysis of the thyroid-stimulating hormone on nonalcoholic fatty liver disease （NAFLD） with Type 2 diabetes mellitus. Methods 92 subjects participated in this study. Depending on NAFLD condition, the research objects were divided into group without NAFLD （ NF group, n = 32） and group with NAFLD （F group, n =60）. The patients＇weight, blood pressure, blood glucose, serum lipid, serum liver, kidney function, thyroid function were measured and tested, and the correlation between serum TSH levels and the above various indicators and the independent risk factors of NAFLD were analyzed by logistic regression analysis. Results Weight and BMI in F group were significantly higher than that of NF group （P 〈0.01 ） and the levels of GGT, TG, HbAlc, FPG, FINS, HOMA-IR and TSH in F group were higher than those in NF group, however the levels of HDL-C were lower in F group than those in NF group （ P 〈 0.05 or P 〈 0.01 ）. Serum TSH levels were positively related to BMI, GGT, TG, FPG, FINS and HOMA-IR. In logistic regression analysis, the TSH level was an independent risk factor associated with NAFLD. Conclusion The level of TSH tends to increase in NAFLD with Type 2 diabetes mellitus, which is closely related to glucose and lipid metabolism of liver. The TSH may be an independent risk factor in predicting the pathogenesis of NAFLD.

关 键 词：非酒精性脂肪性肝病 糖尿病 2型 代谢综合征 促甲状腺素 

分 类 号：R575.5[医药卫生—消化系统] R587.1[医药卫生—内科学]