2型糖尿病患者甲状腺激素敏感性受损与动脉粥样硬化相关性的研究  

Relationship between impaired thyroid hormone sensitivity and atherosclerosis in patients with type 2 diabetes mellitus

作　　者：杨青青[1] 李辉[2] 赵文娣[1] 吴晨辰 李敏[1] 胡小磊[1] 孙卫华[1] 时照明[1] 金国玺[1] YANG Qingqing;LI Hui;ZHAO Wendi(Department of Endocrinology,The First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)

机构地区：[1]蚌埠医学院第一附属医院内分泌科,233000 [2]蚌埠医学院第一附属医院心血管内科,233000

出　　处：《中国糖尿病杂志》2024年第4期267-270,共4页Chinese Journal of Diabetes

基　　金：安徽省高等学校自然科学研究重点项目(2022AH051420);蚌埠医学院自然科学重点项目(2020byzd072)。

摘　　要：目的 探讨T2DM患者甲状腺功能指标及甲状腺激素敏感性受损与动脉粥样硬化(AS)的相关性。方法 选取2022年1~10月于蚌埠医学院第一附属医院内分泌科住院治疗的T2DM患者318例,分为单纯T2DM组(n=149)及T2DM合并AS组(T2DM+AS,n=169)。比较两组甲状腺反馈分位数指数(TFQI)、参数甲状腺反馈分位数指数(PTFQI)、促甲状腺激素细胞-T4抵抗指数(TT4RI)及促甲状腺激素指数(TSHI)等的差异。结果T2DM+AS组年龄、DM病程、WC、FPG、HbA_1c、TC、游离甲状腺素(FT_(4))高于T2DM组(P<0.05),T2DM+AS组游离三碘甲状腺原氨酸(FT_(3))、TFQI及FT_(3)/FT_(4)低于T2DM组(P<0.05)。Spearman相关分析显示,TFQI、TT4RI及TSHI与HDL-C呈正相关(P<0.05),TFQI与TG呈负相关(P<0.05),FT_(3)/FT_(4)与HbA_(1)c呈负相关(P<0.05)。Logistic回归分析显示,年龄、WC、FPG、HbA_(1)c、TC及FT_(3)/FT_(4)是T2DM合并AS的影响因素。受试者工作特征曲线分析显示,FT_(3)/FT_(4)评估T2DM合并AS的曲线下面积为0.787,敏感度、特异度为80.47%、63.09%。结论 甲状腺功能正常的T2DM患者FT_(3)/FT_(4)降低与AS风险增加相关。Objective To explore the relationship between impaired thyroid function,thyroid hormone sensitivity and atherosclerosis(AS)in patients with type 2 diabetes mellitus(T2DM).Methods 318 T2DM patients hospitalized in the Endocrinology Department of The First Affiliated Hospital of Bengbu Medical College from January to October 2022 were selected and divided into simple T2DM group(n=149)and T2DM combined with AS group(T2DM+AS,n=169).Thyroid feedback quantile index(TFQI),parameter thyroid feedback quantile index(PTFQI),thyroid stimulating hormone cell-T4 resistance index(TT4RI)and thyroid stimulating hormone index(TSHI)were compared between two groups.Results The age,DM duration,WC,FPG,HbA_(1)c,TC and FT_(4) in T2DM+AS group were higher than those in T2DM group(P<0.05).The level of FT3,TFQI and FT_(3)/FT_(4) in T2DM+AS group were lower than those in T2DM group(P<0.05).Spearman correlation analysis showed that TFQI,TT4RI and TSHI were positively correlated with HDL-C(P<0.05),TFQI was negatively correlated with TG(P<0.05),and FT_(3)/FT_(4) was negatively correlated with HbA_(1)c(P<0.05).Logistic regression analysis showed that age,WC,FPG,HbA_(1)c,TC and FT_(3)/FT_(4) were the influencing factors of T2DM combined with AS.The analysis of the working characteristic curve of the subjects showed that the area under the curve for FT_(3)/FT_(4) evaluation of T2DM combined with AS was 0.787,with the sensitivity 80.47%and the specificity 63.09%,respectively.Conclusion Reduced FT_(3)/FT_(4) may be associated with an increased risk of AS in T2DM patients among euthyroid population.

关 键 词：糖尿病 2型 动脉粥样硬化 甲状腺激素敏感性 

分 类 号：R58[医药卫生—内分泌]