2型糖尿病合并亚临床甲状腺功能减退的临床特征  

Clinical features of type 2 diabetes mellitus with subclinical hypothyroidism

作　　者：陈晓蕾[1] 田林玉 张建伟[1] 柯亭羽[2] 石薇[1] 周珈莉[1] 蔡丽萍[1] 刘娜[1] 段学葵[1] 

机构地区：[1]昆明市第一人民医院内分泌科,650031 [2]昆明医科大学第二附属医院老年内分泌科

出　　处：《中国糖尿病杂志》2016年第10期923-927,共5页Chinese Journal of Diabetes

基　　金：昆明市科技局项目(2014-04-A-S-02-3118)

摘　　要：目的观察T2DM合并亚临床甲状腺功能减退(SCH)患者的临床特征。方法收集154例T2DM合并SCH患者(T2DM-SCH组)及183例单纯T2DM住院患者(T2DM组)资料及相关检查,并进行统计分析。结果 T2DM患者中,SCH患病率约18.1%。T2DM-SCH组eGFR较T2DM组降低,胱抑素C(Cys-C)较T2DM组升高(P<0.05)。校正年龄、病程、BMI及HbA_1c后,TSH与Cys-C呈正相关(r=0.291,P<0.01)。T2DM-SCH组年龄高、病程长、高血压及DR患病率高于T2DM组(P<0.05)。T2DM-SCH组血清游离甲状腺素(FT4)低于T2DM组,SUA、2hIns高于T2DM组(P<0.05)。结论 T2DM患者SCH患病率高。SCH患者糖脂代谢异常状态明显,SCH与糖尿病慢性肾脏疾病(CKD)、DR及高血压相关。T2DM患者筛查SCH有临床意义。Objective To compare clinical features of type 2diabetes mellitus（T2DM）with and without subclinical hypothyroidism（SCH）. Methods A total of 154T2 DM patients with SCH（T2DMSCH group）and 183 T2 DM patients without SCH（T2DM group）were enrolled in this study.Clinical materials and tests results were collected and used for statistical analysis. Results The prevalence of SCH was 18.1% in patients with T2 DM.Kidney glomerular filtration rate index（eGFR）decreased and Cystatin-C（Cys-C）increased significantly in T2DM-SCH group than in T2 DM group（P〈0.05）.TSH and Cys-C had positive correlation after adjustment of age,duration of disease,BMI and HbA1c（r=0.291,P〈0.01）.Age,duration of diabetes,prevalence of hypertension and diabetic retinopathy were significantly higher in T2DM-SCH group than in T2 DM group（P〈0.05）.FT_4 was lower,but uric acid and2 hpostprandial insulin were higher in T2DM-SCH group than in T2 DM group（P〈0.05）.Conclusion The prevalence of SCH is higher in patients with T2 DM.Glucose and lipid metabolism is significantly abnormal in T2DM-SCH group.SCH was associated with chronic kidney disease（CKD）,DR and hypertension.Early screening for SCH is valuable in patients with T2 DM.

关 键 词：糖尿病 2型 亚临床甲状腺机能减退 糖尿病微血管并发症 糖尿病慢性肾脏疾病 糖尿病性视网膜病变 

分 类 号：R587.1[医药卫生—内分泌] R581.2[医药卫生—内科学]