不同性别甲状腺功能正常的2型糖尿病患者甲状腺激素敏感性指标对糖尿病周围神经病变的影响  

Effect of thyroid hormone sensitivity indexes on diabetic peripheral neuropathy in type 2 diabetic patients with normal thyroid function of different genders

作　　者：时淑薇 汲宝兰 赵红艳 高冠起[2] SHI Shuwei;JI Baolan;ZHAO Hongyan;GAO Guanqi(School of Clinical Medicine,Shandong Second Medical University,Shandong Province,Weifang261000,China;Department of Endocrinology,Linyi People’s Hospital,Shandong Province,Linyi276000,China)

机构地区：[1]山东第二医科大学临床医学院,山东潍坊261000 [2]山东省临沂市人民医院内分泌科,山东临沂276000

出　　处：《中国医药导报》2025年第8期108-114,共7页China Medical Herald

摘　　要：目的 探讨不同性别甲状腺功能正常的2型糖尿病(T2DM)患者甲状腺激素敏感性指标与糖尿病周围神经病变(DPN)的相关性。方法 选取2020年1月至2023年3月在山东省临沂市人民医院内分泌科住院的1 965例甲状腺功能正常的T2DM患者作为研究对象,根据患者是否发生DPN分为对照组和DPN组。收集患者的一般资料及实验室指标,分析不同性别甲状腺功能正常的T2DM患者发生DPN的影响因素。结果 在女性患者中,DPN组年龄、糖尿病病程、血肌酐、尿白蛋白肌酐比(UACR)及糖尿病视网膜病变(DR)和外周动脉粥样硬化(PAS)占比高于对照组,而体重指数(BMI)、舒张压、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、尿酸、血红蛋白、游离三碘甲状腺原氨酸(FT3)、甲状腺反馈分位数指数(TFQIFT3)及非酒精性脂肪性肝病(NAFLD)占比低于对照组(P<0.05)。在男性患者中,DPN组年龄、糖尿病病程、高密度脂蛋白胆固醇(HDL-C)、UACR及DR和PAS占比高于对照组,而BMI、内脏脂肪面积、皮下脂肪面积、舒张压、总胆固醇、甘油三酯、空腹血糖、ALT、AST、血红蛋白、FT3、TFQIFT3及NAFLD占比低于对照组(P<0.05)。在女性患者中,糖尿病病程(OR=1.056)、TFQIFT3(OR=0.653)、DR(OR=2.036)是甲状腺功能正常的T2DM患者发生DPN的影响因素(P<0.05);在男性患者中,糖尿病病程(OR=1.047)、HDL-C(OR=2.931)、DR(OR=1.470)、NAFLD(OR=0.558)是甲状腺功能正常的T2DM患者发生DPN的影响因素(P<0.05)。结论 在甲状腺功能正常的女性T2DM患者中,TFQIFT3水平与DPN风险密切相关,在此人群中监测TFQIFT3水平对降低DPN发生率具有重要意义。Objective To explore the correlation between thyroid hormone sensitivity indexes and diabetic peripheral neu-ropathy(DPN)in type 2 diabetes mellitus(T2DM)patients with normal thyroid function of different genders.Methods A total of 1965 T2DM with normal thyroid function who were hospitalized in the Department of Endocrinology,Linyi People’s Hospital,Shandong Province from January 2020 to March 2023 were selected as study objects.They were divided into control group and DPN group according to whether DPN occurred.General data and laboratory indicators were collected,and the factors affecting DPN in T2DM patients with normal thyroid function of different genders were analyzed.Results In female patients,age,diabetic course,serum creatinine,urinary albumin creatinine ratio(UACR),the proportion of diabetic retinopathy(DR)and the proportion of peripheral atherosclerosis(PAS)in DPN group were higher than those in control group;while body mass index(BMI),diastolic blood pressure,alanine transaminase(ALT),aspartate transaminase(AST),uric acid,hemoglobin,free triiodothyronine(FT3),thyroid feedback quantile index based on FT3(TFQIFT3),and the proportion of non-alcoholic fatty liver disease(NAFLD)were lower than those in control group(P<0.05).In male patients,age,diabetes course,high-density lipoprotein cholesterol(HDL-C),UACR,and the percentages of DR and PAS in DPN group were higher than those in control group;while BMI,visceral fat area,subcutaneous fat area,diastolic blood pressure,total cholesterol,triglycerides,fasting blood glucose,ALT,AST,hemoglobin,FT3,TFQIFT3,and the percentage of NAFLD were lower than those in control group(P<0.05).In female patients, diabetes course (OR=1.056), TFQIFT3 (OR=0.653), and DR (OR=2.036) were the influencing factors for DPN in T2DM patients with normal thyroid function (P<0.05);in male patients, diabetes course (OR=1.047), HDL-C (OR= 2.931), DR (OR=1.470), and NAFLD (OR=0.558) were the influencing factors for DPN in T2DM patients with normal thyroid function (P<0.05). Conclusion TFQI

关 键 词：2型糖尿病 糖尿病周围神经病变 甲状腺激素 甲状腺激素敏感性指标 

分 类 号：R587.1[医药卫生—内分泌]