甲状腺功能对老年2型糖尿病患者微炎症状态及缺血性心脑血管病的影响  

The Influence of Thyroid Function on the Micro Inflammatory Status and Ischemic Cardio-cerebrovascular Disease in Elderly T2DM Patients

作　　者：尹飞[1] 李志红[2] 李海明 李芳[1] 姚明言[4] YIN Fei;LI Zhihong;LI Haiming;LI Fang;YAO Mingyan(The Second Department of Endocrinology,The First Central Hospital of Baoding,Baoding 071000,China;The First Central Hospital of Baoding City,Baoding 071000,China;Department of Cardiovascular Medicine,Affiliated Hospital of Hebei University,Baoding 071000,China;Department of Endocrinology,The First Central Hospital of Baoding,Baoding 071000,China)

机构地区：[1]保定市第一中心医院内分泌二科,河北保定071000 [2]保定市第一中心医院,河北保定071000 [3]河北大学附属医院心血管内科,河北保定071000 [4]保定市第一中心医院内分泌四科,河北保定071000

出　　处：《标记免疫分析与临床》2025年第1期104-110,共7页Labeled Immunoassays and Clinical Medicine

基　　金：2020年保定市科技计划自筹经费项目(第一批)(编号:2041ZF076)。

摘　　要：目的探讨甲状腺功能对老年2型糖尿病(T2DM)患者微炎症状态及缺血性心脑血管病的影响。方法回顾性分析本院2021年6月至2023年6月收治的265例老年T2DM患者的临床资料,根据甲状腺功能将其分为正常组、减退组、亢进组,比较3组甲状腺激素水平、微炎症状态指标。采用Pearson法分析甲状腺功能与微炎症状态指标的相关性以及使用降糖、降压、降脂药物与微炎症状态指标的相关性。另根据老年T2DM患者是否发生缺血性心脑血管病将其分为并发组和无并发组,比较两组一般资料。采用Logistic回归分析法分析老年T2DM患者发生缺血性心脑血管病的危险因素。结果亢进组三碘甲状腺原氨酸(TT_(3)),总甲状腺素(TT_(4)),游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平均高于正常组、减退组(P<0.05);减退组促甲状腺激素(TSH)、白细胞介素-6(IL-6)、IL-17、超敏-C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平均高于正常组(P<0.05);正常组、减退组TSH水平均高于亢进组(P<0.05);减退组老年T2DM患者IL-6、IL-17、hs-CRP、TNF-α水平均与TSH水平呈正相关(P<0.05);并发组TSH、IL-6、IL-17、hs-CRP、TNF-α水平均高于无并发组(P<0.05);多因素Logistic回归分析显示,TSH、IL-6、IL-17、hs-CRP、TNF-α水平均是老年T2DM患者发生缺血性心脑血管病的危险因素(P<0.05)。结论老年T2DM患者存在甲状腺功能异常,以甲状腺功能减退为主,且TSH水平与微炎症状态指标均呈正相关,另上述指标均是老年T2DM患者发生缺血性心脑血管病的影响因素。Objective To investigate the influence of thyroid function on the state of micro inflammation and ischemic cardio-cerebrovascular disease in elderly patients with type 2 diabetes(T2DM).Methods The clinical data of 265 elderly T2DM patients admitted to our hospital from June,2021 to June,2023 were retrospectively analyzed.These patients were divided into the normal group,hypothyroidism group and hyperthyroidism group according to thyroid function.Thyroid hormone levels and micro inflammatory status indicators were then compared among the three groups.The correlation between thyroid function and micro inflammatory state indicators and the correlation between the use of hypoglycemic,antihypertensive and lipid-lowering drugs and micro inflammatory state indicators were evaluated by Pearson correlation method.In addition,the elderly T2DM patients were divided into the concurrent group and non-concurrent group according to whether they had ischemic cardiovascular and cerebrovascular disease,and the general information of the two groups were compared.The risk factors for ischemic cardio-cerebrovascular disease in elderly T2DM patients was identified by multivariate logistic regression method.Results The levels of triiodothyronine(TT_(3)),total thyroxine(TT_(4)),free triiodothyronine(FT_3),and free thyroxine(FT_4)in the hyperthyroidism group were significantly higher than those in the normal group and the hypothyroidism group(P<0.05).The levels of thyroid stimulating hormone(TSH),interleukin-6(IL-6),IL-17,high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α)in the hypothyroidism group were significantly higher than those in the normal group(P<0.05).The TSH levels in both the normal and hypothyroidism groups were significantly higher than those in the hyperthyroidism group(P<0.05).The levels of IL-6,IL-17,hs-CRP and TNF-αin elderly T2DM patients of hypothyroidism group were positively correlated with TSH levels(P<0.05).The levels of TSH,IL-6,IL-17,hs-CRP and TNF-αin the concurrent group were si

关 键 词：甲状腺功能 老年 2型糖尿病 微炎症状态 缺血性心脑血管病 

分 类 号：R587.1[医药卫生—内分泌]