C肽与2型糖尿病合并亚临床甲状腺功能异常的关系  

Association between C-peptide and Sub-clinical Thyroid Dysfunction in Type 2 Diabetic Patients

作　　者：崔琦 杨春杰 孟令伟 隋晓婵 关宝杰 管园园 CUI Qi;YANG Chunjie;MENG Lingwei(Department of Endocrinology,Jilin Province FAW General Hospital,Jilin 130011,China)

机构地区：[1]吉林省一汽总医院内分泌科,长春130011

出　　处：《医学研究杂志》2022年第1期69-73,共5页Journal of Medical Research

基　　金：吉林省自然科学基金资助项目(20200201587JC)。

摘　　要：目的探讨在2型糖尿病患者中血清C肽浓度与亚临床甲状腺功能异常的关系。方法筛选就诊于笔者医院内分泌科的2型糖尿病患者397例,根据甲状腺功能测定结果分为亚临床甲状腺功能减退症(SCHypo)组(n=136)、亚临床甲状腺功能亢进症(SCHyper)组(n=61)、甲状腺功能正常组(n=200)。所有患者均检测空腹血清C肽,馒头餐后1、2、3h的血清C肽,糖化血红蛋白等指标。结果与甲状腺功能正常组比较,SCHypo组的年龄较大,FBG较低,吸烟率、BMI、空腹C肽及餐后3h C肽均较高(P<0.05);亚临床甲状腺功能亢进症组的BMI、TG及LDL-C均较低,高血压患病率及餐后3h C肽较高(P<0.05)。SCHypo与2型糖尿病患者是否吸烟、年龄、BMI、空腹血糖有相关性(P<0.05),SCHyper与2型糖尿病患者的糖尿病病程、高血压、BMI、血脂(TG及LDL-C)有相关性(P<0.05)。经Logistic回归分析,矫正各混杂因素后,空腹及馒头餐后3h血清C肽与2型糖尿病患者SCHypo呈正相关(β=1.713,95%CI:2.598~11.846,P<0.001;β=1.013,95%CI:1.926~3.934,P<0.001);仅馒头餐后3h血清C肽可能与SCHyper呈正相关(β=1.332,95%CI:2.079~6.905,P<0.001)。结论血清C肽可能为2型糖尿病患者亚临床甲状腺功能异常的独立危险因素。Objective To investigate the relationship between C-peptide and Subclinical thyroid dysfunction in patients with type 2 diabetes.Methods We screened 397 patients with type 2 diabetes who were admitted to the Endocrinology Department of our hospital.After thyroid function testing,they were divided into three groups:type 2 diabetes with subclinical hypothyroidism(136 cases),type 2 diabetes with subclinical hyperthyroidism(61 cases)and type 2 diabetes with normal thyroid function(200 cases).Their medical history and the laboratory data were collected such as fasting serum C-peptide levels and postprandial serum C-peptide levels of 1 hours,2 hours and 3 hours,glycated hemoglobin(HbA1c)and so on.Results Compared with the normal thyroid function group,the subclinical hypothyroidism group was older,had lower fasting blood glucose(FBG),and had higher smoking rate,BMI,fasting C-peptide and 3 hours serum C-peptide levels.In the subclinical hyperthyroidism group,body mass index(BMI),TG and LDL-C were lower,and the prevalence of hypertension and 3 hours serum C-peptide levels were higher.There were significant relationships between type 2 diabetes with subclinical hypothyroidism and smoking,age,BMI and FBG(P<0.05).Subclinical hyperthyroidism was related to the course of diabetes,the prevalence of hypertension,BMI and lipids profiles(TG and LDL-C)in patients with type 2 diabetes(P<0.05).Logistic regression analysis showed that after adjusting for the confounding factors,fasting and 3 hours serum C-peptide levels were positively related to type 2 diabetes with subclinical hypothyroidism(β=1.713,95%CI:2.598-11.846,P<0.001;β=1.013,95%CI 1.926-3.934,P<0.001).Only 3 hours postprandial serum C-peptide levels were positively related to type 2 diabetes with subclinical hyperthyroidism(β=1.332,95%CI:2.079-6.905,P<0.001).Conclusion According to the results,serum C-peptide level may be an independent associated factors with subclinical thyroid dysfunction in type 2 diabetes.

关 键 词：2型糖尿病 C肽 亚临床 甲状腺功能减退症 甲状腺功能亢进症 

分 类 号：R589[医药卫生—内分泌]