甲状腺功能正常的新诊断型糖尿病患者促甲状腺激素水平与体内脂肪分布相关研究  

Association between Thyroid-stimulating Hormone Level and Body Fat Distribution in Euthyroid Individuals With Newly Diagnosed Type 2 Diabetes

作　　者：桑谊荃 孙妍 刘学奎 耿厚法 徐伟 梁军 Sang Yiquan;Sun Yan;Liu Xuekui(Department of Endocrinology,Xuzhou Central Hospital,Jiangsu 221009,China)

机构地区：[1]徐州市中心医院、东南大学医学院附属徐州医院、徐州医科大学徐州临床学院内分泌科,221000

出　　处：《医学研究杂志》2021年第12期116-120,8,共6页Journal of Medical Research

基　　金：江苏省徐州市科技计划项目(KC18195)。

摘　　要：目的研究甲状腺功能正常的新诊断2型糖尿病患者血清促甲状腺激素(TSH)水平与定量CT测定的腹部皮下脂肪面积(SFA)、内脏脂肪面积(VFA)、肝脏脂肪含量的相关性,探讨正常范围内的血清促甲状腺激素水平对体内脂肪分布的影响。方法回顾性分析2016年2月~2019年1月于徐州市中心医院内分泌科住院治疗的新诊断的2型糖尿病患者的临床资料,排除甲状腺功能异常、肝脏疾病及大量饮酒的患者,共126例患者纳入研究,收集患者的临床资料,采用定量CT(QCT)工作站测量患者的SFA、VFA、肝脏脂肪含量,根据TSH正常范围,将TSH分为3组,即低水平组(0.3~1.6mU/L)、中水平组(1.61~2.9mU/L)和高水平组(2.91~5.0mU/L),比较不同水平的TSH与SFA、VFA、肝脏脂肪含量的差异,应用Pearson相关检验及多因素线性回归模型进行数据分析。结果在甲状腺功能正常的新诊断2型糖尿病患者中,TSH相对高水平组体重指数(BMI)、糖化血红白蛋白(HbA1c)、谷草转氨酶(ALT)、SFA显著高于低水平组(P<0.05),Spearman相关检验发现TSH与SFA(r=0.189,P=0.036)呈正相关,与VFA、肝脏脂肪含量无关。多元逐步回归分析发现,TSH是SFA增加的独立危险因素。结论甲状腺功能正常的新诊断2型糖尿病患者TSH可作为腹部皮下脂肪增加的血清标志物,即使甲状腺功能在正常范围内,血清TSH可能参与体内脂肪分布的调节。Objective To evaluate the correlation of serum thyroid-stimulating hormone(TSH)levels with subcutaneous fat area(SFA),visceral fat area(VFA),and liver fat content in the abdomen via quantitative CT in newly diagnosed type 2 diabetes patients with normal thyroid function,and to investigate the effects of variations in serum TSH levels within a normal range and body fat distribution.Methods The clinical data of newly diagnosed type 2 diabetes patients hospitalized in the Endocrinology Department of Xuzhou Central Hospital between February 2016 and January 2019 were retrospectively analyzed.Patients with thyroid dysfunction,hepatic diseases,and heavy drinking were excluded.A total of 126 patients were included in the study.Clinical patient data were collected and a quantitative CT(QCT)workstation was used to measure the SFA,VFA,and liver fat content of the patients.The patients were divided into three groups based on the normal range of TSH to compare the differences among different TSH levels and SFA,VFA,and liver fat content:the low TSH level group(0.3-1.6 mIU/L),medium TSH level group(1.61-2.9 mIU/L),and high TSH level group(2.91-5.0 mIU/L).Pearson correlation test and multivariate linear regression analysis were performed for data analysis.Results In newly diagnosed type 2 diabetes patients with normal thyroid function,body mass index(BMI),glycosylated hemoglobin(HbA1c),aspartate aminotransferase(AST),and SFA were significantly higher in the high TSH level group than in the low TSH level group(P<0.05).The Spearman correlation analysis indicated that TSH was positively correlated with SFA(r=0.189,P=0.036).However,no correlation with VFA and liver fat content was observed.Multivariate linear regression analysis demonstrated that TSH can be considered to be a serum biomarker for increased abdominal subcutaneous fat.Conclusion In newly diagnosed type 2 diabetes patients with normal thyroid function,an increase in TSH to a higher level can be considered as a serum biomarker for increased abdominal subcutaneous fat.Fu

关 键 词：促甲状腺激素 2型糖尿病 定量CT 腹部脂肪 非酒精性脂肪肝 

分 类 号：R587[医药卫生—内分泌]