2型糖尿病合并亚临床甲状腺功能减退症患者HOMA-IR HOMA-ISLET与TSH水平的关系研究  

Relationship Between HOMA-IR HOMA-ISLET and TSH in Patients with Type 2 Diabetes Mellitus and Subclinical Hypothyroidism

作　　者：高婷婷[1] 周玉荣 葛勇[1] 沈小静[1] 时训婷 GAO Tingting;ZHOU Yurong;GE Yong(Chuzhou First People's Hospital,Anhui Chuzhou 239000,China)

机构地区：[1]安徽省滁州市第一人民医院内分泌二科,安徽滁州239000

出　　处：《河北医学》2025年第1期146-150,共5页Hebei Medicine

基　　金：2018年安徽省自然科学基金项目,(编号:1808085MH236)。

摘　　要：目的:探究2型糖尿病合并亚临床甲状腺功能减退症(甲减)患者的胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-ISLET)与促甲状腺激素(TSH)水平的关系。方法:选取102例在我院治疗的2型糖尿病合并亚临床甲减患者,收治时间为2019年10月至2024年10月,根据TSH水平分为正常组(n=49)和升高组(n=53),正常组:TSH(0.3-3.6)mIU/L,升高组:TSH>3.6mIU/L。收集两组患者的基本资料,检测所有患者血糖指标,计算HOMA-IR、HOMA-ISLET值。比较两组基本资料、HOMA-IR、HOMA-ISLET水平;采用Spearman法分析HOMA-IR、HOMA-ISLET与TSH水平的相关性;ROC曲线分析HOMA-IR、HOMA-ISLET对TSH水平的预测价值。结果:两组基本资料比较差异无统计学意义,具有可比性(P>0.05);与正常组相比,升高组HOMA-IR水平更高,HOMA-ISLET水平更高(P<0.05);HOMA-IR、HOMA-ISLET与TSH水平呈正相关(P<0.05);ROC曲线分析显示,HOMA-IR对TSH升高的预测特异度高,HOMA-ISLET的曲线下面积和灵敏度高。结论:2型糖尿病合并亚临床甲减患者HOMA-IR、HOMA-ISLET与TSH水平呈正相关,HOMA-IR、HOMA-ISLET对TSH升高具有一定的预测价值,HOMA-ISLET的预测效能更高。Objective:To investigate the relationship between the insulin resistance index(HOMA-IR),isletβ-cell function index(HOMA-ISLET),and thyroid-stimulating hormone(TSH)in patients with type 2 diabetes mellitus(T2DM)complicated by subclinical hypothyroidism(SCH).Methods:One hundred and two patients with T2DM and SCH who received treatment at the hospital from October 2019 to October 2024 were selected and divided into two groups based on TSH levels:the normal group(n=49)and the elevated group(n=53).The normal group had TSH levels of 0.3-3.6 mIU/L,while the elevated group had TSH levels>3.6 mIU/L.Basic data for both groups were collected,and blood glucose indices were measured for all patients to calculate HOMA-IR and HOMA-ISLET.Basic data,HOMA-IR,and HOMA-ISLET were compared between the two groups.The Spearman method was used to analyze the correlation between HOMA-IR,HOMA-ISLET,and TSH.ROC curve analysis was performed to assess the predictive value of HOMA-IR and HOMA-ISLET on TSH levels.Results:There were no significant differences in basic data between the two groups(P>0.05).Compared with the normal group,the HOMA-IR level was higher and the HOMA-ISLET level was higher in the elevated group(P<0.05).HOMA-IR and HOMA-ISLET were positively correlated with TSH levels(P<0.05).ROC curve analysis showed that HOMA-IR had high predictive specificity for TSH elevation,while HOMA-ISLET had a high area under the curve and sensitivity.Conclusion:HOMA-IR and HOMA-ISLET are positively correlated with TSH levels in patients with type 2 diabetes mellitus combined with subclinical hypothyroidism.HOMA-IR and HOMA-ISLET have certain predictive value for TSH elevation,with HOMA-ISLET demonstrating higher predictive efficacy.

关 键 词：胰岛素抵抗指数 胰岛β细胞功能指数 促甲状腺激素 亚临床甲状腺功能减退症 

分 类 号：R581.2[医药卫生—内分泌] R587.2[医药卫生—内科学]