25(OH)D对2型糖尿病患者TSH水平的影响  

Effects of 25(OH)D on TSH levels in patients with type 2 diabetes

作　　者：李红艳[1] 孟祥凤[1] 栾守婧 黄灵玉[1] 刘海霞[1] 明义[1] LI Hongyan;MENG Xiangfeng;LUAN Shoujing;HUANG Lingyu;LIU Haixia;MING Yi(Endocrinology Department of Weifang People’s Hospital,Weifang 261041,China)

机构地区：[1]潍坊市人民医院内分泌科,山东潍坊261041

出　　处：《潍坊医学院学报》2021年第5期352-354,共3页Acta Academiae Medicinae Weifang

基　　金：潍坊市卫生健康委科研项目(项目编号:WFWSJK-2020-001)。

摘　　要：目的探讨25(OH)D对老年2型糖尿病患者TSH水平的影响。方法研究对象分为TSH水平正常组和水平升高组,测量身高、体重,并计算体重指数(BMI);静脉采血测定25(OH)D、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、抗甲状腺球蛋白抗体(TGAB)、抗甲状腺过氧化物酶抗体(TPOAb)、空腹血糖(FBG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1C)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)。结果与TSH水平正常组比较,TSH水平升高组25(OH)D显著降低,差异有统计学意义(P<0.01);Pearson双变量相关分析显示:TSH水平与25(OH)D、FT4呈负相关(P<0.01);与BMI、FBG、HbA1C、TG、FINS、HOMA-IR呈正相关(P<0.01);25(OH)D(B=-0.128,P=0.000)、HOMA-IR(B=-0.018,P=0.002)、TG(B=0.541,P=0.031)是2型糖尿病患者TSH水平升高的独立危险因素。结论维生素D缺乏、胰岛素抵抗、甘油三酯升高是导致老年2型糖尿病患者TSH水平升高的重要原因。Objective To investigate the effect of 25(OH)D on TSH level in elderly patients with type 2 diabetes mellitus.Methods The subjects were divided into two groups:normal TSH group and elevated TSH group.Height and weight were measured and body mass index(BMI)was calculated.Venous sampling measurement of 25(OH)D,three free iodine thyroid glycine(FT3)and free thyroxine(FT4),thyroid stimulating hormone(TSH),thyroglobulin antibody(TGAB)resistance,resistance to thyroid peroxidase antibody(TPOAb),fasting blood glucose(FBG),fasting insulin(FINS),glycosylated hemoglobin(HbA1C),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C).Results Compared with the normal group,25(OH)D in the elevated group was significantly decreased(P<0.01).Pearson bivariate correlation analysis showed that TSH level was negatively correlated with 25(OH)D and FT4,and the difference was statistically significant(P<0.01).Was positively correlated with BMI,FBG,HbA1c,TG,FINS,HOMA-IR(P<0.01);25(OH)D(B=-0.128,P=0.000),HOMA-IR(B=-0.018,P=0.002)and TG(B=0.541,P=0.031)were independent risk factors for elevated TSH level in type 2 diabetes.Conclusion Vitamin D deficiency,insulin resistance and elevated triglycerides are the important causes of elevated TSH levels in elderly patients with type 2 diabetes.

关 键 词：2型糖尿病 老年 25(OH)D 胰岛素抵抗 高TSH水平 

分 类 号：R587.1[医药卫生—内分泌]