肺结核患者血清促甲状腺激素和糖化血红蛋白的相关性分析  

Correlation analysis between serum thyroid stimulating hormone and glycosylated hemoglobin in patients with pulmonary tuberculosis

作　　者：玉海玲[1] 韦礼斌[1] 蒙伟宗[1] 黄捷 Yu Hailing;Wei Libin;Meng Weizong;Huang Jie(Laboratory Department,The Fourth People’s Hospital of Nanning,Nanning 530023,China)

机构地区：[1]南宁市第四人民医院检验科,南宁530023

出　　处：《广西医科大学学报》2021年第11期2173-2178,共6页Journal of Guangxi Medical University

基　　金：广西壮族自治区卫生健康委员会(No.Z20211331);广西壮族自治区卫生和计划生育委员会(No.Z20170148)。

摘　　要：目的:探讨肺结核患者血清促甲状腺激素(TSH)和糖化血红蛋白(HbA1c)的关系。方法:选取南宁市第四人民医院2016年3月至2017年4月收治的431例肺结核患者,依据TSH值将患者分为对照组(336例,TSH正常)和观察组(95例,TSH升高)。比较两组患者的各项资料,分析肺结核患者TSH升高的危险因素,并分析不同性别肺结核患者血清TSH与HbA1c的关联性。结果:两组患者的年龄、腰围、FPG、糖耐量试验2 h血糖、HbA1c、高密度脂蛋白(HDL-C)比较差异统计学有意义(均P<0.05)。多因素logistic回归分析显示,年龄、腰围、空腹血糖(FPG)、糖耐量试验2 h血糖、HbA1c、HDL-C为肺结核患者血清TSH升高的危险因素(均P<0.05)。男性患者血清TSH是影响HbA1c的独立因素,两者呈负相关关系(OR=0.678,95%CI:0.456~0.962,P=0.031),但在女性患者中,血清TSH与HbA1c无明显相关性(OR=0.874,95%CI:0.754~1.036,P=0.119)。ROC分析结果显示,男性患者血清TSH判断HbA1c升高的准确性较高(AUC=0.769,P=0.019)。结论:血清TSH水平为肺结核患者HbA1c异常的危险因素,且男性患者血清TSH水平与HbA1c的关系较女性更密切。Objective:To investigate the association between serum thyroid stimulating hormone(TSH) and glycosylated hemoglobin(HbA1 c) in patients with pulmonary tuberculosis.Methods:A total of 431 pulmonary tuberculosis patients in our hospital from March 2016 to April 2017 were selected,and were divided into a control group(336 cases,TSH at the normal level) and an observation group(95 cases,TSH at the high level).The general data of two groups’ patients were compared.The risk factors of elevated TSH in patients with pulmonary tuberculosis and the correlation between serum TSH and HbA1 c in patients with pulmonary tuberculosis of different genders were analyzed.Results:The differences in the age,waist circumference,FPG,2 h blood glucose,HbA1 c,and HDL-C between the two groups were statistically significant(P<0.05).Multivariate logistic regression analysis showed that the age,waist circumference,FPG,2 h blood glucose,HbA1 c,and HDL-C were risk factors for elevated serum TSH in pulmonary tuberculosis patients(P<0.05).Serum TSH in males was an independent factor affecting HbA1 c,and it was negatively correlated with HbA1 c(OR=0.678,95% CI:0.456-0.962,P=0.031),but no significant correlation was found in females(OR=0.874,95% CI:0.754-1.036,P=0.119).ROC curve indicated that the accuracy of serum TSH in male patients was higher in determining HbA1 c elevation(AUC=0.769,P=0.019).Conclusion:Serum TSH level is a risk factor for abnormal HbA1 c in pulmonary tuberculosis patients;the relationship between serum TSH level and HbA1 c in male patients is closer than that in females.

关 键 词：肺结核 血清促甲状腺激素 糖化血红蛋白 

分 类 号：R587.1[医药卫生—内分泌] R58[医药卫生—内科学]