甲状腺功能参数与简易胰岛素敏感性指数的相关性  

The relationships between thyroid function parameters and simplified insulin sensitivity indexes

作　　者：朱启波 杨思珏 王巍[3] 关海霞 Zhu Qibo;Yang Sijue;Wang Wei;Guan Haixia(Department of Endocrinology,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences;Department of Endocrinology and Metabolism;The First Hospital of China Medical University3.Department of Physical Examination Center,The First Hospital of China Medical University)

机构地区：[1]广东省人民医院·广东省医学科学院内分泌科,广州510080 [2]中国医科大学附属第一医院内分泌科,沈阳110001 [3]中国医科大学附属第一医院体检中心,沈阳110001

出　　处：《重庆医科大学学报》2022年第11期1333-1338,共6页Journal of Chongqing Medical University

基　　金：国家自然科学基金资助项目(编号:82170803、81870538)。

摘　　要：目的:探索甲状腺功能正常人群中简易胰岛素敏感性指数与甲状腺激素水平及甲状腺激素敏感性的关系。方法:纳入4 909名2017年1月至2018年12月于中国医科大学附属第一医院进行体检的甲状腺功能正常人群。计算甲状腺反馈分位数指数(thyroid feedback quantile-based index,TFQI)和游离三碘甲状腺原氨酸与游离甲状腺素比值(free triiodothyronine to free thyroxine ratio,FT3/FT4)评估甲状腺激素敏感性。简易胰岛素敏感性指数包括甘油三酯-葡萄糖指数(triglyceride glucose index,TyG)、TyG-体质指数、TyG-腰围、甘油三酯与高密度脂蛋白胆固醇比值、内脏脂肪指数和脂质蓄积指数。结果:多重线性回归分析显示,FT3/FT4、FT3和促甲状腺激素(thyroid stimulating hormone,TSH)与TyG呈正相关(β分别为1.651、0.122和0.060);FT4与TyG呈负相关(β=-0.026,均P=0.000)。Logistic回归分析显示,FT3/FT4增加1个标准差,TyG升高(位于最高四分位数组)的比值比为1.282,95%可信区间为1.193~1.379。FT3和TSH增加是TyG升高的危险因素。FT4增加与TyG升高风险降低相关。使用其他简易胰岛素敏感性指数进行验证,或根据性别、体质指数、甲状腺自身抗体水平分组仍能得到上述结果。TFQI仅与部分简易胰岛素敏感性指数升高相关。结论:简易胰岛素敏感性指数与甲状腺激素敏感性及激素水平具有较好相关性,为评估甲状腺功能与胰岛素敏感性的关联提供更简便的工具。Objective:To evaluate the relationships of thyroid hormone levels and thyroid hormone sensitivity with simplified insulin sensitivity indexes in euthyroid individuals.Methods:The study enrolled 4 909 euthyroid individuals who underwent a health examination at The First Hospital of China Medical University between January 2017 and December 2018. Thyroid feedback quantile-based index(TFQI)and free triiodothyronine to free thyroxine ratio(FT3/FT4)were calculated to reflex thyroid hormone sensitivity. Simplified insulin sensitivity indexes included triglyceride glucose index(TyG),TyG-body mass index,TyG-waist circumference,triglyceride to high-density lipoprotein-cholesterol ratio,visceral adiposity index and lipid accumulation product.Results:Multiple linear regression analyses showed that FT3/FT4,FT3 and thyroid stimulating hormone(TSH)were positively associated with TyG(β=1.651,0.122 and0.060,respectively);FT4 was negatively associated with TyG(β=-0.026,all P=0.000). Logistic regression showed that,with 1 SD increase in FT3/FT4,the odds ratio for high TyG,which was defined as the highest quartiles was 1.282,95% confidence interval was from 1.193 to 1.379. The risk for high TyG increased with the increases of FT3 and TSH,and decreased with the increase of FT4. Other simplified insulin sensitivity indexes showed similar relationships with the above thyroid parameters. These results were remained when we grouped people according to gender,body mass index,and the levels of thyroid autoantibodies. TFQI was only associated with a part of simplified insulin sensitivity indexes.Conclusion:Simplified insulin sensitivity indexes are associated with thyroid hormone sensitivity and serum hormone levels. They provided an easy tool for evaluating the relationships between thyroid function and insulin sensitivity.

关 键 词：甲状腺功能 甲状腺激素敏感性 胰岛素敏感性 甘油三酯-葡萄糖指数 

分 类 号：R581[医药卫生—内分泌]