高胰岛素血症与亚临床甲减患者颈动脉粥样硬化的关系  

Relationship between hyperinsulinemia and carotid atherosclerosis in patients with subclinical hypothyroidism

作　　者：曾濒洁 张倩 刘瑜[2] 陈春强 Zeng Binjie;Zhang Qian;Liu Yu;Chen Chunqiang(School of Clinical Medicine,Weifang Medical University,Weifang 261000,Shandong,China;Department of General Practice,Affiliated Hospital of Weifang Medical University,Weifang 261000,Shandong,China;Department of Vascular Surgery,Liaocheng People's Hospital,Liaocheng 252000,Shandong,China)

机构地区：[1]潍坊医学院临床医学院,山东潍坊261000 [2]潍坊医学院附属医院全科医学科,山东潍坊261000 [3]聊城市人民医院血管外科,山东聊城252000

出　　处：《血管与腔内血管外科杂志》2024年第6期724-728,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨高胰岛素血症(HINS)与亚临床甲状腺功能减退(SCH)患者发生颈动脉粥样硬化的关系。方法收集2020年9月至2022年12月于潍坊医学院附属医院住院的305例SCH患者的临床资料,按照HINS发生情况将其分为HINS组(n=166)和NHINS组(n=139)。收集患者的相关指标,采用Pearson或Spearman分析SCH患者颈动脉内膜中层厚度(CIMT)的影响因素,应用Logistic回归模型分析SCH合并HINS患者发生颈动脉粥样硬化的危险因素。结果两组患者糖尿病、高血压、收缩压(SBP)、舒张压(DBP)、体重指数(BMI)、稳态模型胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、2 h胰岛素(2 h INS)、空腹C肽、2 h C肽、CIMT、颈动脉粥样硬化发生率比较,差异均有统计学意义(P﹤0.05)。Pearson或Spearman相关性分析结果显示,CIMT与年龄、高血压、HOMA-IR、FINS、2 h INS、空腹C肽、2 h C肽、LDL-C、促甲状腺激素(TSH)均呈正相关(P﹤0.05)。Logistic回归模型分析结果显示,HINS、年龄、TSH均是发生颈动脉粥样硬化的影响因素(P﹤0.05)。结论HINS、年龄、TSH均是SCH患者发生颈动脉粥样硬化的影响因素,SCH合并HINS患者发生颈动脉粥样硬化风险更高。Objective To investigate the relationship between hyperinsulinemia(HINS)and carotid atherosclerosis in subclinical hypothyroidism(SCH)patients.Method Clinical data of 305 SCH patients hospitalized in the Affiliated Hospital of Weifang Medical University from September 2020 to December 2022 were collected.According to the occurrence of HINS,they were divided into HINS group(n=166)and NHINS group(n=139).The relevant indicators of the patients were collected,the influencing factors of carotid intimax-media thickness(CIMT)in SCH patients were analyzed by Pearson or Spearman,the risk factors of carotid atherosclerosis in SCH patients with HINS were analyzed by Logistic regression model.Result There were significant differences in the incidence of diabetes,hypertension,systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass index(BMI),homeostasis model insulin resistance index(HOMA-IR),glycosylated hemoglobin(HbA1c),fasting insulin(FINS),2-hour insulin 2 h INS,fasting C-peptide,2 h C-peptide,CIMT,and carotid atherosclerosis between the two groups(P<0.05).The Pearson or Spearman correlation analysis results showed that CIMT were positively correlated with age,hypertension HOMA-IR,FINS,2 h INS,fasting C-peptide,2-hour C-peptide,LDL-C,and thyroid stimulating hormone(TSH)(P<0.05).Logistic regression model analysis showed that HINS,age and TSH were the influencing factors of carotid atherosclerosis(P<0.05).Conclusion HINS,age and TSH are the influencing factors of carotid atherosclerosis,patients with SCH and HINS have a higher risk of carotid atherosclerosis.

关 键 词：高胰岛素血症 胰岛素抵抗 亚临床甲状腺功能减退 颈动脉内膜-中膜厚度 颈动脉粥样硬化 

分 类 号：R543[医药卫生—心血管疾病]