2型糖尿病老年患者促甲状腺素水平与心血管风险因素的关联分析  

Relationship between thyrotropin levels and cardiovascular risk factors in elderly patients with type 2diabetes mellitus

作　　者：吴金婵 陈娟[1] 冯光球[1] 管频[1] wu Jinchan;Chen Juan;Feng Guangqiu;Guan Pin(Medical Care Center,Hainan Affiliated Hospital of Hainan Medical University,Haikou570311,China)

机构地区：[1]海南省人民医院海南医学院附属海南医院医疗保健中心,海口570311

出　　处：《中华老年医学杂志》2021年第6期749-751,共3页Chinese Journal of Geriatrics

摘　　要：目的︰探讨甲状腺功能正常的老年2型糖尿病(T2DM)患者血清促甲状腺素(TSH)水平与主要心血管风险因素之间的关系。方法︰510例甲状腺功能正常的老年T2DM患者纳入本研究,其中男265例、女245例。所有患者隔夜空腹采血,收集患者甲状腺功能、血脂水平、血糖、糖化血红蛋白(HbA1c)等检测结果,采集所有患者的相关基本信息并计算体质指数(BMTI)、内脏脂肪指数(VAI)和脂质蓄积指数(LAP)。结果﹐高TSH组患者BMI、VAI、LAP、三酰甘油(TG)、总胆固醇(TC),低密度脂蛋白(LDL-C)水平以及HbAlc、空腹血糖(FBG)和餐后2h血糖(2h PBG)分别为(31.7±5.5)kg/m^(2)、7.20±1.18,61.88±6.36、(6.49±2.64)mmol/L、(2.73±1.30)mmol/L、(2.86±0.93)mmol/L,(9.10±1.35)%、(9.64±2.03)mmol/L、(19.20±2.99)mmol/L,均高于低TSH组(27.6±2.1)kg/m^(2)、5.88±0.51、52.76±7.09,(5.84±2.41)mmol/L、(1.99±0.54)mmol/L、(2.55±0.81)mmol/L,(7.80±1.76)%、(7.55±1.72)mmol/L、(15.33±2.36)mmol/L(t=5.32、8.06、10.88,8.13,8.30、5.90、5.83,6.51,6.82,均P≤0.05);多因素Logistic回归分析结果显示,HbA1c(OR=1.21,95%CI:1.01~1.52,P=0.020),LDL-C(OR=1.88、95%CI:1.78-2.01、P=0.000)、LAP(OR=3.01、95%CI:2.98~3.12、P=0.010),BMIOR=2.58、95%CI;2.45~2.68、P=0.000)这些心血管危险因素均为TSH的影响因素。结论老年T2DM患者即使TSH在正常范围内的高限也与内脏脂肪增多﹑高TG血症等心血管风险因素密切相关,可能增加心血管疾病的风险。Objective To investigate the relationship between serum thyrotropin(TSH)levelsand major cardiovascular risk factors in elderly type 2 diabetes(T2DM)patients with normal thyroidfunction.Methods A total of 510 elderly T2DM patients with normal thyroid function wereincluded in this study,including 265 males and 245 females.Blood samples of all patients werecollected after an overnight fast.Thyroid function and blood levels of lipids,glucose,glycatedhemoglobin(HbAlc)and other components were measured.Basic information of all patients wascollected and body mass index(BMI),visceral adiposity index(VAI)and lipid accumulation productindex(LAP)were calculated.Results The levels of BMI,VAI,LAP,triglycerides(TG),totalcholesterol(TC),low density lipoprotein(LDL-C),HbA1c,fasting blood glucose(FBG)and 2h-postprandial blood glucose(2 h PBG)were higher in the high TSH group than in the low TSH group(31.7±5.5 kg/m^(2)vs.27.6±2.1 kg/m^(3),7.20±1.18 vs.5.88±0.51,61.88±6.36 vs.52.76±7.09,6.49±2.64 mmol/L vs.5.84±2.41 mmol/L,2.73±1.30 mmol/L vs.1.99±0.54 mmol/L,(2.86±0.93 mmol/L vs.2.55±0.81 mmol/1,9.10±1.35%vs.7.80±1.76%,9.64±2.03 mmol/Lvs.7.55±1.72 mmol/L,19.20±2.99 mmol/L vs.15.33±2.36 mmol/L,t=5.32,8.06,10.88,8.13,8.30,5.90,5.83,6.51 and 6.82,all P<0.05).Multivariate Logistic regression analysis showed that cardiovascular risk factors including HbAlc(OR=1.21,95%CI,1.01-1.52,P=0.020),LDL-C(OR=1.88,95%CI:1.78-2.01,P=0.000),LAP(OR=3.01,95%CI:2.98-3.12,P=0.010),andBMI(OR=2.58,95%CI:2.45-2.68,P=0.000)were influencing factors for TSH.Conclusions In elderly patients with T2DM,TSH levels within the normal range but close to the upper limit are closely related to cardiovascular risk factors such as increased visceral fat and high TG levels,and may increase the risk of cardiovascular disease.

关 键 词：糖尿病 2型 促甲状腺素 心血管疾病 

分 类 号：R587.1[医药卫生—内分泌]