2型糖尿病周围神经病变病人甲状腺激素及抗体表达水平变化的研究  

Study on the changes in thyroid hormone and antibody expression levels in patients with type 2 diabetic peripheral neuropathy

作　　者：杨玮 张倩为 陈巧云 任婷婷 张佳华 索丽霞 YANG Wei;ZHANG Qianwei;CHEN Qiaoyun;REN Tingting;ZHANG Jiahua;SUO Lixia(Department of Endocrinology,Jiading District Central Hospital Affiliated to Shanghai University of Medicine&Health Sciences,Shanghai 201800,China)

机构地区：[1]上海健康医学院附属嘉定区中心医院内分泌科,上海201800

出　　处：《安徽医药》2022年第4期697-701,共5页Anhui Medical and Pharmaceutical Journal

基　　金：上海市嘉定区卫生和计划生育委员会项目(2017-KY-05)。

摘　　要：目的 探讨2型糖尿病周围神经性病变(DPN)病人甲状腺激素及抗体水平的变化及临床意义。方法 选取2018年12月至2019年12月于上海健康医学院附属嘉定区中心医院住院2型糖尿病病人共260例,其中观察组为2型糖尿病周围神经性病变病人(n=128),对照组为单纯2型糖尿病病人(n=132)。收集两组病人的性别、年龄、糖尿病病程、体质量指数(BMI),检测两组空腹血糖(FPG)、糖化血红蛋白(HbA1c)、促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、抗甲状腺球蛋白抗体(TG-Ab)、抗甲状腺过氧化物酶抗体(TPO-Ab)、促甲状腺激素受体抗体(TR-Ab)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)表达水平。结果 观察组甲状腺功能异常的患病率(26.56%)高于对照组(18.18%),TSH(2.59±1.36)mU/L高于对照组(2.24±0.86)mU/L(P<0.05),观察组FT3(3.76±0.54)ng/L低于对照组(3.92±0.69)ng/L(P<0.05)。观察组中女性亚组TG-Ab(2.24±1.55)IU/mL、HbA1c(10.67±2.32)%高于男性亚组(1.75±1.18)IU/mL、(9.35±1.76)%(P<0.05)。Spearman相关分析显示,FT3与BMI呈正相关(P<0.01),与年龄、HbA1c呈负相关(P<0.01);FT4与年龄、病程呈负相关(P<0.05),与TPO-Ab呈正相关(P<0.01)。多元逐步回归分析显示,年龄、BMI与HbA1c是FT3的影响因素(P<0.01),TPO-Ab是FT4的独立影响因素(P<0.05)。结论 DPN病人甲状腺功能异常的患病率较高,甲状腺功能状态对2型糖尿病合并DPN病人病情评估及预后判断具有一定的临床参考价值。Objective To investigate the changes and clinical significance of thyroid hormone and antibody levels in patients with type 2 diabetic peripheral neuropathy (DPN).Methods A total of 260 patients with type 2 diabetes were selected from December 2018to December 2019 in Jiading District Central Hospital Affiliated to Shanghai University of Medicine&Health Sciences.Among them,the observation group was patients with type 2 diabetes peripheral neuropathy (n=128),and the control group was patients with type 2diabetes alone (n=132).The sex,age,duration of diabetes and body mass index (BMI) of the two groups of patients were collected,and levels of fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),thyroid stimulating hormone (TSH),free triiodothyronine(FT3),free thyroxine (FT4),anti-thyroglobulin antibody (TG-Ab),anti-thyroid peroxidase antibody (TPO-Ab),thyroid stimulating hormone receptor antibody (TR-Ab),total cholesterol (TC),triglyceride (TG),high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were detected in the two groups.Results The prevalence of abnormal thyroid function in the observation group (26.56%) was higher than that in the control group (18.18%),and TSH (2.59±1.36) mU/L was higher than that in the control group (2.24±0.86) mU/L (P<0.05).The level of FT3 in the observation group (3.76±0.54)ng/Lwas lower than that in the control group(3.92±0.69) ng/L (P<0.05).The female TG-Ab (2.24±1.55) IU/mL and HbA1c (10.67±2.32)%in the observation group were higher than those of the male (1.75±1.18) IU/mL,(9.35±1.76)%(P<0.05).Spearman correlation analysis showed that FT3 was positively correlated with BMI (P<0.01) and negatively correlated with age and HbA1c (P<0.01);FT4 was negatively correlated with age and disease course (P<0.05) and positively correlated with TPO-Ab (P<0.01).Multiple stepwise regression analysis showed that age,BMI and HbA1c were the influencing factors of FT3 (P<0.01),and TPO-Ab was an independent influencing factor of FT4 (P<0.05).Conclu

关 键 词：糖尿病神经病变 促甲状腺素 免疫球蛋白类 甲状腺刺激 甲状腺激素 体质量指数 

分 类 号：R587.2[医药卫生—内分泌]