2型糖尿病糖化血红蛋白水平与亚临床甲减相关性研究  

The Study of the correlation between glycosylated hemoglobin level and subclinical hypothyroidism in type 2 diabetic patients

作　　者：韩肖[1] 董砚虎[2] 侯舒婷 AN Xiao;DONG Yan-hu;HOU Shu-ting(Department of Internal Medicine,Weifang Mdeical College,Weifang,Shandong 261000,China)

机构地区：[1]潍坊医学院,山东潍坊261000 [2]青岛内分泌糖尿病医院

出　　处：《青岛医药卫生》2018年第1期24-27,共4页Qingdao Medical Journal

摘　　要：目的分析2型糖尿病患者糖化血红蛋白水平与亚临床甲状腺功能减退患病率的关系。方法选择2型糖尿病患者674例,健康体检者267例。采用化学发光法测定血清游离三碘甲腺原氨酸(FT_3)、游离甲状腺素(FT_4)、促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPO-Ab)、甲状腺球蛋白抗体(TG-Ab)水平,同时测定2型糖尿病患者糖化血红蛋白(HbA1c)、总胆固醇(CHOL)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)。为了更好地观察糖化血红蛋白水平与亚临床甲状腺功能的患病率之间的关系,将2型糖尿病患者根据其糖化血红蛋白水平分为以下5组:(1)HbA1C<7%组(151例)、(2)7%≤HbA1C<8%组(116例)、(3)8%≤HbA1C<9%组(125例)、(4)9≤HbA1C<10%组(118例)、(5)10%≤HbA1C组(164例)。结果 2型糖尿病组患者FT_4、FT_3均较健康对照组患者水平低,TSH水平高于健康对照组,差异有统计学意义(P<0.05)。7%≤HbA1C<8%组、8%≤HbA1C<9%组、9≤HbA1C<10%组、10%≤HbA1C组的TG、LDL-C明显高于HbA1C<7%组,差异有统计学意义(P<0.05),随着糖化血红蛋白水平的升高,2型糖尿病患者患有亚临床甲状腺功能减退的比例升高。结论 2型糖尿病患者亚临床甲状腺功能减退的发生率较高,且与糖尿病患者糖化血红蛋白的水平呈正相关,并对糖尿病患者的糖脂代谢有重要意义。Objective To investigate the relationship between the level of glycosylated hemoglobin and the prevalence of subclinical hypothyroidism in patients with type 2 diabetes mellitus.Meth-ods A total of 674 patients with type 2 diabetes were elected and 267 healthy subjects were selected.Free triiodothyronine(FT 3),Freethyroxine(FT 4),thyroid stimulating hormone(TSH),thyroid peroxidase antibody(TPO-Ab)are measured by chemiluminescent immunoassay.thyroglobulin antibody(TG)and thyroglobulin(TG)were measured by chemiluminescence method.At the sanme time,the glycosylated hemoglobin(HbA1C),Low-density lipoprotein cholesterol(LDL-C),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),total cholesterol(CHOL)of 2 diabetes are counted.In order to observe the relationship between glycosylated hemoglobin levels and the prevalence of subclinical thyroid function,patients with type 2 diabetes were divided into the following five groups according to their glycosylated hemoglobin levels,HbA1C<7%group(151 cases),7%(116 cases),8%≤HbA1C<9%group(125 cases),9≤HbA1C<10%group(118 cases),10%≤HbA1C group(164 cases).Results The levels of FT 4 and FT 3 in type 2 diabetes mellitus group were lower than those in healthy control group,and TSH level was higher than that of healthy control group(P<0.05).The levels of TG and LDL-C in 7%≤HbA1C<8%group,8%≤HbA1C<9%group,9≤HbA1C<10%group and 10%≤HbA1C group were significantly higher than those in HbA1C<7%group,and the difference was statistically(P<0.05).With the increase of glycosylated hemoglobin,the proportion of subclinical hypothyroidism in type 2 diabetic patients increased.Conclusion The incidence of subclinical hypothyroidism in type 2 diabetes mellitus is higher than that in diabetic patients,and it is positively correlated with the level of glycosylated hemoglobin in diabetic patients,and it is important for the metabolism of glucose and lipid in diabetic patients.

关 键 词：2型糖尿病 甲状腺功能 糖化血红蛋白 

分 类 号：R587.1[医药卫生—内分泌]