亚临床甲状腺功能减低对糖化血红蛋白筛查糖尿病患者阈值的影响  

Effect of subclinical hypothyroidism on the threshold of glycosylated hemoglobin screening for diabetic patients

作　　者：朱丹华[1] 郑桂梅[1] 孙致连[1] 廖镜波 李红晖[1] ZHU Dan-hua;ZHENG Gui-mei;SUN Zhi-lian(Shenzhen People’s Hospital,Shenzhen 518000,China)

机构地区：[1]深圳市罗湖区人民医院

出　　处：《中国处方药》2019年第12期128-130,共3页Journal of China Prescription Drug

摘　　要：目的探讨甲状腺功能对糖化血红蛋白筛查糖尿病患者阈值切点的影响。方法选取健康对照组40例与2016年5月~2017年5月于深圳市罗湖区人民医院内分泌科住院亚临床甲状腺功能减退症的非糖尿病患者38例作为研究组,分别测定血清游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)及促甲状腺激素(TSH),血红蛋白(HGB)、平均红细胞体积(MCV)、平均红细胞血红蛋白量(MCH)、糖化血红蛋白(HbA1c),分析甲状腺功能与HbA1c的相关性,应用Spearman相关性分析进行统计学分析。结果与对照组比较,研究组血清TSH水平更高(P <0.05),研究组平均HbA1c为(5.71±0.36)%,对照组平均HbA1c为(5.25±0.21)%,两组差异有统计学意义(P <0.05),研究组HGB、MCV、MCH与对照组相比,差异均有统计学意义(P均<0.05),且研究组HGB、MCV、MCH均低于对照组。经Pearson’s相关分析,所有入组对象,血清TSH与HbA1c之间呈正相关(r=0.48,P <0.01)。结论非糖尿病的亚临床甲状腺功能减退症患者,可能对其HbA1c产生影响。以HbA1c筛查亚临床甲状腺功能减退症患者的糖尿病或前驱糖尿病时,必须考虑升高的TSH水平对HbA1c的影响。Objective To investigate the effect of thyroid function on the threshold cut-off of glycosylated hemoglobin in diabetic patients. Methods 40 healthy people were randomly enrolled as control group.38 non-diabetic patients with subclinical hypothyroidism in the Department of Endocrinology in Luohu District People’s Hospital of Shenzhen city, during May 2016 to May 2017, were randomly enrolled in study group. The levels of the serum free triiodothyronine(FT3),free thyroxine(FT4),thyroid-stimulating hormone(TSH), hemoglobin(HGB), mean corpuscular volume(MCV), mean corpuscular hemoglobin(MCH), glycosylated hemoglobin(Hb A1 c) were detected. And the correlation between thyroid function and Hb A1 c was analyzed with Spearman correlation analysis for statistical analysis. Results Compared with the control group, the serum TSH level of the study group was higher(P < 0.05). The mean Hb A1 c of the study group was 5.71±0.36%, and the mean Hb A1 c of the control group was 5.25±0.21%. The difference between the two groups was statistically significant(P< 0.05). Compared with the control group, the HGB, MCV and MCH of the study group were statistically different(P < 0.05). And the HGB, MCV and MCH of the study group were lower than the control group. According to Pearson’s correlation analysis, there was a positive correlation between serum TSH and Hb A1 c in all subjects(r = 0.48, P < 0.01). Conclusion Patients with non-diabetic subclinical hypothyroidism may have an effect on their Hb A1 c. When screening for diabetes or pre-diabetes in patients with subclinical hypothyroidism using detect of Hb A1 c, the effect of elevated TSH levels on Hb A1 c must be considered.

关 键 词：甲状腺功能 糖化血红蛋白 2型糖尿病 甲状腺激素 

分 类 号：R58[医药卫生—内分泌]