2型糖尿病患者甲状腺功能与血糖、颈动脉内膜中层厚度及斑块积分的关系  

Relationship between thyroid function in patients with type 2 diabetes mellitus and blood sugar,IMT and carotid plaque score

作　　者：王娟[1] 高学祥[1] 殷应传 汪六庆[1] 蒋文韬 韩成建 Wang Juan;Gao Xuexiang;Yin Yingzhuan;Wang Liuqing;Jiang Wentao;Han Chengjian(Department of Laboratory Medicine,Hefei Third People's Hospital,Hefei 230001,China;不详)

机构地区：[1]合肥市第三人民医院检验科,合肥230001 [2]合肥市第三人民医院内分泌科,合肥230001

出　　处：《中国临床保健杂志》2023年第3期347-351,共5页Chinese Journal of Clinical Healthcare

基　　金：安徽医科大学校科研基金项目(2020xkj258)。

摘　　要：目的探讨2型糖尿病患者甲状腺功能与血糖、颈动脉内膜中层厚度(IMT)、颈动脉斑块积分的关系。方法选取2018年5月至2021年9月合肥市第三人民医院收治的2型糖尿病患者204例,均对其行甲状腺功能[三碘甲状腺原氨酸(TT_(3))、游离三碘甲状腺原氨酸(FT_(3))、甲状腺激素(TT_(4))、游离甲状腺素(FT_(4))、促甲状腺激素(TSH)]、糖代谢相关指标[空腹血糖(FPG)、空腹胰岛素(FIns)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)]及颈动脉IMT检测,并评估颈动脉斑块积分。根据甲状腺激素水平将所有患者分为正常组、甲状腺功能减退(甲减)组、甲状腺功能亢进(甲亢)组,对比各组糖代谢相关指标水平、颈动脉IMT及颈动脉斑块积分,并采用Pearson相关性分析法分析各项指标之间的相关性。结果204例2型糖尿病患者中,正常组126例,甲减组61例,甲亢组17例。甲减组及甲亢组颈动脉IMT及颈动脉斑块积分均明显高于正常组(P<0.05),甲亢组FPG、2 hPG、HbA1c、HOMA-IR均明显高于正常组与甲减组(P<0.05)。相关性分析结果显示,在甲减组及甲亢组中,TT_(3)、FT_(3)、TT_(4)、FT_(4)与FPG、2 hPG、HbA1c、HOMA-IR均呈正相关(P<0.05),与FIns呈负相关(P<0.05);此外,TT_(3)、FT_(3)、TT_(4)、FT_(4)与颈动脉IMT、颈动脉斑块积分在甲减组及甲亢组中分别呈负相关和正相关(P<0.05);甲减组的TSH与FPG、2 hPG、HbA1c、HOMA-IR均呈负相关(P<0.05),与FIns、颈动脉IMT、颈动脉斑块积分均呈正相关(P<0.05)。结论2型糖尿病患者存在甲状腺功能异常情况,并以亚临床甲减及临床甲减为主,2型糖尿病并甲状腺功能异常者与糖代谢、颈动脉IMT、颈动脉斑块积分关系密切。Objective To investigate the relationship between thyroid function and blood sugar,carotid intima-media thickness(IMT)and carotid plaque score in patients with type 2 diabetes mellitus.Methods Two hundred and four patients with type 2 diabetes admitted to Hefei Third People's Hospital from May 2018 to September 2021 were selected,who were detected with Thyroid function[triiodothyronine(TT_(3)),free triiodothyronine(FT_(3)),thyroid hormone(TT_(4)),free thyroxine(FT_(4)),thyroid stimulating hormone(TSH)],related indicators of glucose metabolism[fasting blood glucose(FPG),fasting insulin(FIns),postprandial 2 h blood glucose(2 hPG),glycosylated hemoglobin(HbA1c),insulin resistance index(HOMA-IR)]and carotid IMT,and the carotid plaque score was also assessed.According to thyroid hormone level,all patients were divided into normal thyroid function group(normal group),hypothyroidism group(hypothyroidism group,including clinical hypothyroidism and hypothyroidism),hyperthyroidism group(hyperthyroidism group,including clinical hyperthyroidism and hyperthyroidism),and the levels of related indicators of glucose metabolism,carotid IMT and carotid plaque scores were compared,and the correlation between thyroid function and glucose metabolism,carotid IMT and carotid plaque score in type 2 diabetes mellitus were analyzed by Pearson correlation analysis method.Results There were 126 in the normal group of 204 patients with type 2 diabetes,61 in hypothyroidism group and 17 in hyperthyroidism group.The carotid IMT and carotid plaque scores in hypothyroidism group and hyperthyroidism group were significantly higher than those in normal group(P<0.05),and FPG,2 hPG,HbA1c and HOMA-IR in hyperthyroidism group were significantly higher than those in normal group and hypothyroidism group(P<0.05).The results of correlation analysis showed that TT_(3),FT_(3),TT_(4),and FT_(4) were positively correlated with FPG,2 hPG,HbA1c,HOMA-IR(P<0.05),and negatively correlated with FIns(P<0.05)in hypothyroidism and hyperthyroidism groups.In addition,TT

关 键 词：糖尿病 2型 甲状腺功能亢进症 甲状腺功能减退症 颈动脉内膜中膜厚度 血糖 

分 类 号：R587.1[医药卫生—内分泌]