2型糖尿病患者甲状腺激素水平与衰弱的关系:一项基于上海市11个社区人群的横断面研究  

Relationship between thyroid hormone levels and frailty in patients with type 2 diabetes mellitus:a cross-sectional study based on 11 communities population

作　　者：柯晨昕 虞博威 王宁荐[1] 陈奕[1] KE Chenxin;YU Bowei;WANG Ningjian;CHEN Yi(Institute and Department of Endocrinology and Metabolism,Shanghai Ninth People’s Hospital,Shanghai JiaoTong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院内分泌科,上海200011

出　　处：《新医学》2025年第2期124-130,共7页Journal of New Medicine

基　　金：国家自然科学基金(81800694,82370862)。

摘　　要：目的探讨2型糖尿病患者甲状腺激素水平与衰弱的关系。方法研究数据来源于一项横断面研究,即METAL研究(糖尿病慢性并发症危险因素的社区人群5年随访)的随访研究(2023年4月至6月),研究对象为上海市11个社区的897例2型糖尿病成年患者。采用衰弱表型(包括体质量减轻、疲劳、躯体活动量减少、步速下降以及握力下降)来评估机体衰弱程度。记录参与者一般资料,并测定其甲状腺激素[游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、促甲状腺激素(TSH)]水平、甲状腺抗体[甲状腺球蛋白抗体(TgAb)、甲状腺过氧化物酶抗体(TPOAb)]水平等,采用多因素Logistic回归分析甲状腺激素水平与衰弱表型间的关系。结果在多因素Logistic回归分析中,校正年龄、性别、体质量指数(BMI)、吸烟状况、是否合并高血压或心力衰竭、糖尿病病程以及糖化血红蛋白(GHbA1c)后,FT_(3)水平是体质量减轻(OR=0.71,95%CI 0.51~0.99)和低握力(OR=0.61,95%CI 0.43~0.86)的保护因素(均P<0.05)。结论FT_(3)水平与2型糖尿病患者体质量减轻和低握力呈负相关,提示2型糖尿病患者低FT_(3)水平可能与衰弱风险有关。Objective To investigate the relationship between thyroid hormones levels and frailty in patients with type 2 diabetes mellitus(T2DM).Methods Data were obtained from a cross-sectional study,which was a follow-up of the METAL study(a 5-year community-based follow-up study on risk factors for chronic complications of diabetes)conducted from April to June 2023.The study included 897 adult patients with T2DM from 11 communities in Shanghai.The degree of frailty was assessed using the frailty phenotypes,which included weight loss,fatigue,reduced physical activity,decreased walking speed,and reduced grip strength.General information of participants was recorded,and the levels of thyroid hormones[free triiodothyronine(FT_(3)),free thyroxine(FT_(4)),and thyroid-stimulating hormone(TSH)]and thyroid antibodies[thyroglobulin antibody(TgAb)and thyroid peroxidase antibody(TPOAb)]were measured.Multivariate logistic regression analysis was used to examine the relationship between thyroid hormone levels and frailty phenotype.Results After adjusting for age,gender,body mass index(BMI),smoking status,presence of hypertension or heart failure,duration of diabetes and glycated hemoglobin(GHbA1c),multivariate logistic regression analysis showed that FT_(3) levels was the protective factor with weight loss(OR=0.71,95%CI 0.51-0.99)and low grip strength(OR=0.61,95%CI 0.43-0.86)(all P<0.05).Conclusions FT_(3) levels are negatively correlated with weight loss and low grip strength in patients with T2DM,suggesting that low FT_(3) levels may be associated with an increased risk of frailty in this population.

关 键 词：甲状腺激素 衰弱 2型糖尿病 危险因素 

分 类 号：R58[医药卫生—内分泌]