亚临床甲状腺功能减退症与2型糖尿病患者临床生化指标及大血管并发症的相关性  

Effects of Subclinical Hypothyroidism on Metabolic Indexes and Macrovascular Complications in Patients with Type 2 Diabetes Mellitus

作　　者：李蕾 段滨红[2] 王丹[2] 杜馥曼[2] 张晓艺 LI Lei;DUAN Binhong;WANG Dan(Jiamusi University,Jiamusi 154000,China;不详)

机构地区：[1]佳木斯大学,黑龙江佳木斯154000 [2]黑龙江省医院香坊院区,黑龙江哈尔滨150000

出　　处：《航空航天医学杂志》2023年第5期520-523,共4页Journal of Aerospace medicine

摘　　要：目的探讨亚临床甲状腺功能减退症(SCH)对2型糖尿病(T2DM)患者临床生化指标及大血管并发症的影响。方法回顾性收集2020年01月-2021年12月收治的2型糖尿病(T2DM)合并亚临床甲状腺功能减退症(SCH)的患者114例,另选取131例甲状腺功能正常的2型糖尿病(T2DM)患者作为对照组;对比两组各生化指标及大血管并发症发生率的差异。结果(1)2型糖尿病(T2DM)合并亚临床甲状腺功能减退症组(SCH)的同型半胱氨酸(12.68±9.19)umol/L、甘油三酯(5.59±1.87)mmol/L水平高于甲状腺功能正常组,C肽(566.1±286.71)pmol/L水平低于甲状腺功能正常组,差异有统计学意义(P<0.05)。(2)2型糖尿病(T2DM)合并亚临床甲状腺功能减退组(SCH)血清游离三碘甲腺原氨酸(FT3)(3.91±0.64)pmol/L、血清游离甲状腺素(FT4)(12.05±1.34)pmol/L水平低于甲状腺功能正常组,甲状腺过氧化物酶(TPO-AB)(79.04±205.56)IU/ml、甲状腺球蛋白(TG-AB)(37.65±100.37)IU/ml水平显著高于甲状腺功能正常组,差异有统计学意义(P<0.05)。(3)2型糖尿病(T2DM)合并亚临床甲状腺功能减退组(SCH)BMI、胆固醇、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、空腹血糖(FPG)、糖化血红蛋白(HBA1c)、胰岛素抵抗指数(HOMA-IR)与甲功正常组相比,差异均无统计学意义(P>0.05)。结论亚临床甲减状态对T2DM患者的血管内皮状态、胰岛细胞功能、血脂代谢存在影响,及时监测甲状腺功能可为延缓糖尿病及其并发症的发展提供重要的依据。Objective Purpose:To investigate the effects of subclinical hypothyroidism(SCH)on metabolic indexes and macrovascular complications in patients with type 2 diabetes mellitus.Methods 114 patients with type 2 diabetes mellitus(T2DM)complicated with subclinical hypothyroidism(SCH)and 131 patients with T2DM with normal thyroid function were collected retrospectively from January 2020 to December 2021,and the differences of biochemical indexes and incidence of macrovascular complications between the two groups were compared.Results(1)The levels of homocysteine(12.68±9.19)umol/L and triglyceride(5.59±1.87)mmol/L in type 2 diabetes mellitus(T2DM)complicated with subclinical hypothyroidism(SCH)were higher than those in normal thyroid function group,and the level of C peptide(566.1±286.71)pmol/Lwas lower than that in normal thyroid function group,the difference was statistically significant(P<0.01).(2)The levels of serum free triiodothyronine(FT3)(3.91±0.64)pmol/L and serum free thyroxine(FT4)(12.05±1.34)pmol/L in type 2 diabetes mellitus(T2DM)with subclinical hypothyroidism(SCH)group were lower than those in normal thyroid function group,thyroid peroxidase(TPO-AB)(79.04±205.56)IU/ml,and the level of thyroid globulin(TG-AB)(37.65±100.37)IU/ml was significantly higher than that of normal thyroid function group(P<0.05).(3)There was no significant difference in BMI,cholesterol,low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),fasting blood glucose(FPG),glycosylated hemoglobin(HBA1c)and insulin resistance index(HOMA-IR)between type 2 diabetes mellitus complicated with subclinical hypothyroidism(SCH)group and normal group.Conclusions Clinical hypothyroidism affects the vascular endothelial state,islet cell function and blood lipid metabolism of T2DM patients.Timely monitoring of thyroid function can provide an important basis for delaying the development of diabetes and its complications.

关 键 词：亚临床甲状腺功能减退症 2型糖尿病 大血管并发症 

分 类 号：R581.2[医药卫生—内分泌]