T2DM合并甲状腺功能亢进的影响因素及血清GDF-15、NRG4联合检测的诊断效能  

Influencing Factors in T2DM Complicated with Hyperthyroidism and Diagnostic Efficacy of Serum GDF-15 Combined with NRG4

作　　者：陈丽 夏云亚 CHEN Li;XIA Yunya(Gaoyou People's Hospital,Gaoyou 225600,China)

机构地区：[1]高邮市人民医院,江苏高邮225600

出　　处：《中外医学研究》2025年第8期54-57,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:研究2型糖尿病(type 2 diabetes,T2DM)合并甲状腺功能亢进(简称甲亢)的影响因素及血清生长分化因子-15(growth differentiation factor-15,GDF-15)、神经调节蛋白4(neuregulin 4,NRG4)联合检测的诊断效能。方法:选取2021年3月—2023年3月高邮市人民医院收治的120例T2DM患者开展研究。将其按照合并甲亢与否分为甲亢组(n=35)与无甲亢组(n=85)。对比两组各项基线资料与实验室指标水平。通过多因素logistic回归分析明确T2DM合并甲亢的影响因素。另以受试者工作特征(receiver operating characteristic,ROC)曲线明确血清GDF-15、NRG4单独及联合检测T2DM患者合并甲亢的诊断效能。结果:甲亢组空腹血糖(fasting blood glucose,FBG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、胰岛素抵抗指数(homeostasis model assessment of insulin resistance index,HOMA-IR)、游离三碘甲状腺原氨酸(free triiodothyronine,FT_(3))、游离四碘甲状腺原氨酸(free tetraiodothyroxine,FT_(4))、GDF-15、NRG4水平均高于无甲亢组,而促甲状腺激素(thyroid stimulating hormone,TSH)水平低于无甲亢组,差异有统计学意义(P<0.05);两组性别、年龄、体重指数(body mass index,BMI)、吸烟、饮酒情况对比,差异无统计学意义(P>0.05)。多因素logistic回归分析显示,T2DM患者合并甲亢的影响因素包括FBG、HbA1c、HOMA-IR、FT_(3)、FT_(4)、TSH、GDF-15、NRG4(P<0.05)。经ROC曲线分析证实,GDF-15、NRG4联合预测T2DM患者合并甲亢的曲线下面积为0.846,高于单独检测的0.768、0.775。结论:T2DM患者合并甲亢的影响因素为FBG、HbA1c、HOMA-IR、FT_(3)、FT_(4)、TSH、GDF-15、NRG4,且GDF-15、NRG4联合检测可实现对T2DM患者合并甲亢的有效诊断。Objective:To study the influence factor of type 2 diabetes mellitus(T2DM)complicated with hyperthyroidism and the diagnostic efficacy of serum growth differentiation factor-15(GDF-15)combined with and neuregulin 4(NRG4).Method:A total of 120 T2DM patients admitted to Gaoyou People's Hospital from March 2021 to March 2023 were studied.They were divided into hyperthyroidism group(n=35)and non-hyperthyroidism group(n=85)according to whether complicated with hyperthyroidism.Baseline data and laboratory indicators were compared between the two groups.The influencing factors of T2DM complicated with hyperthyroidism were determined by multivariate logistic regression analysis.Receiver operating characteristic(ROC)curve was also used to determine the efficacy of serum GDF-15 and NRG4 levels in diagnosing T2DM complicated with Hyperthyroidism patients.Result:Fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),homeostasis model assessment of insulin resistance index(HOMA-IR),free triiodothyronine(FT_(3)),free tetraiodothyronine(FT_(4)),GDF-15 and NRG4 in hyperthyroidism group were higher than those in non-hyperthyroidism group,the level of thyroid stimulating hormone(TSH)was lower than that of non-hyperthyroidism group,and the differences were statistically significant(P<0.05).There were no significant differences in gender,age,body mass index(BMI),smoking and drinking situation between the two groups(P>0.05).Multivariate logistic regression analysis confirmed that the influencing factors ofT2DM complicated with hyperthyroidism patients included FBG,HbA1c,HOMA-IR,FT_(3),FT_(4),TSH,GDF-15 and NRG4(P<0.05).ROC curve analysis confirmed that the area under the curve of GDF-15 and NRG4 combined to predict T2DM complicated with hyperthyroidism was 0.846,higher than 0.768 and 0.775 of individual detection.Conclusion:The influencing factors of T2DM complicated with hyperthyroidism patients are FBG,HbA1c,HOMA-IR,FT_(3),FT_(4),TSH,GDF-15 and NRG4,and the combined detection of GDF-15 and NRG4 can effectively diagnose T2DM compl

关 键 词：2型糖尿病 甲状腺功能亢进 生长分化因子-15 神经调节蛋白4 诊断 

分 类 号：R58[医药卫生—内分泌]