血清25-(OH)D_(3)、IL-21水平与2型糖尿病合并桥本甲状腺炎老年患者甲状腺功能的相关性分析  

Correlation analysis of serum 25-(OH)D_(3) and interleukin-21 levels with thyroid function in elderly patients with type 2 diabetes mellitus complicated with Hashimoto’s thyroiditis

作　　者：刘鹏[1] 张晖[1] 常毅娜[1] 张颖裕 LIU Peng;ZHANG Hui;CHANG Yi-na;ZHANG Ying-yu(Department of Endocrinology,First Affiliated Hospital of Henan University of Science and Technology,Henan 471000,China)

机构地区：[1]河南科技大学第一附属医院内分泌科,河南洛阳471000

出　　处：《中国卫生检验杂志》2023年第20期2533-2536,2545,共5页Chinese Journal of Health Laboratory Technology

摘　　要：目的检测2型糖尿病(T2DM)合并桥本甲状腺炎(HT)患者中血清25羟维生素D_(3)[25-(OH)D_(3)]、白细胞介素-21(IL-21)变化,并分析二者与甲状腺功能及与合并HT风险的关系。方法选取2020年3月—2022年6月本院收治的老年T2DM患者153例,根据是否合并HT分为单纯T2DM组(97例)、T2DM合并HT组(56例)。比较2组一般资料、25-(OH)D_(3)、IL-21水平,分析T2DM合并HT组血清25-(OH)D_(3)、IL-21与甲状腺指标相关性,采用logistic回归分析老年T2DM患者合并HT的影响因素。结果T2DM合并HT组中女性占比大于单纯T2DM组,游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))水平低于单纯T2DM组,促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)水平高于单纯T2DM组(P<0.05);T2DM合并HT组血清25-(OH)D_(3)水平低于单纯T2DM组,IL-21水平高于单纯T2DM组(P<0.05);T2DM合并HT患者血清25-(OH)D_(3)与TSH、TPOAb成负相关关系,IL-21与TSH、TPOAb成正相关关系(P<0.05)。结论IL-21是老年T2DM患者合并HT的独立危险因素,25-(OH)D_(3)是老年T2DM患者合并HT的独立保护因素,且二者均与TSH、TPOAb水平密切相关。Objective The serum levels of 25 hydroxyvitamin D_(3)[25-(OH)D_(3)]and interleukin-21(IL-21)in patients with type 2 diabetes mellitus(T2DM)complicated with Hashimoto’s thyroiditis(HT)were determined,and their relationship with thyroid function and risk of HT was analyzed.Methods A total of 153 elderly patients with T2DM admitted to our hospital from March 2020 to June 2022 were selected.They were divided into simple T2DM group(97 cases)and T2DM combined with HT group(56 cases)according to whether they had HT or not.General data,25-(OH)D_(3)and IL-21 levels were compared between the two groups,and the correlation between serum 25-(OH)D_(3)and IL-21 and thyroid indexes in T2DM patients with HT was analyzed.The influencing factors of HT in elderly patients with T2DM were analyzed by logistic regression.Results The proportion of females in T2DM combined with HT group was higher than that in simple T2DM group,and the levels of free triiodothyronine(FT_(3))and free thyroxin(FT_(4))were lower than those in simple T2DM group.The levels of thyroid stimulating hormone(TSH),thyroid peroxidase antibody(TPOAb)and thyroid globulin antibody(TGAb)were higher than those of simple T2DM group(P<0.05).The serum 25-(OH)D_(3)level in T2DM combined with HT group was lower than that in simple T2DM group,and the serum IL-21 level was higher than that in simple T2DM group(P<0.05).Serum 25-(OH)D_(3)was negatively correlated with TSH and TPOAb in T2DM patients with HT,while IL-21 was positively correlated with TSH and TPOAb(P<0.05).Conclusion IL-21 is an independent risk factor for elderly patients with HT,and 25-(OH)D_(3)is an independent protective factor for elderly patients with HT,both of which are closely correlated with TSH and TPOAb levels.

关 键 词：25羟维生素D_(3) 白细胞介素-21 桥本甲状腺炎 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]