摘要
目的研究亚临床甲状腺功能减退症(subclinical hypothyroidism,SCH)对2型糖尿病患者糖代谢及胰岛功能的影响。方法选取北京同仁医院内分泌科2006年1月至2007年3月间因2型糖尿病住院的全部病人1 170例,除外临床、亚临床甲状腺疾病后剩余1 003例,按系统抽样方法选取其中200例作为甲状腺功能正常组,明确诊断为SCH的127例作为观察组,比较2组间糖代谢指标和胰岛功能的变化。结果观察组空腹血糖(FBG)、餐后2 h血糖(PBG)、糖化血红蛋白(HbA1c)、游离甲状腺素(FT4)明显低于甲状腺功能正常组,促甲状腺素(TSH)、甲状腺球蛋白抗体(TGA)、甲状腺微粒体抗体(TPoAb)明显高于甲状腺功能正常组,C肽释放试验显示观察组基础C肽、馒头餐后3 h C肽明显高于甲状腺功能正常组,相关分析发现FBG、PBG、HbA1c与TSH呈显著负相关,C肽释放试验各点C肽水平与TSH呈正相关。不同TSH水平的SCH患者人口学资料及代谢特点比较显示:TSH>10 mIU/L的SCH患者除BMI(体质量指数)水平显著高于10≥TSH>4 mIU/L者外,其余临床指标差异无统计学意义,2组C肽水平差异也无统计学意义,相关分析发现FBG、PBG、HbA1c,C肽释放实验各点C肽水平与TSH均未达到显著相关。非SCH组与SCH组之间胰岛素治疗的比率分别为95.5%和95.3%,差异无统计学意义。结论SCH影响糖代谢,在年龄和病程匹配的情况下,合并SCH使2型糖尿病患者C肽水平升高,血糖水平降低,且随SCH病情加重而明显。
Objective To investigate glucose metabolism in type 2 diabetics with subclinical hypothyroidism（SCH）. Methods The study population consisted of 1 170 cases of type 2 diabetics registered in Beijing Tongren Hospital, and the clinical biochemistry indexes, the functions of thyroid and pancreas islets were examined in the SCH patients and non-SCH type 2 diabetic patients. Results In SCH group, the levels of FBG, PBG, HbA1 c and FT4 were significantly lower, and the levels of TSH, TGA, TPoAb were significantly higher than non-SCH group. In SCH group which TSH 〉 10 mIU/L, the levels of BMI were significantly higher than that of 10≥ TSH 〉 4 mIU/L. The C-peptide released test showed that the C-peptide levels of underlying and 3 h after intake 100 g carbohydrate were significantly higher in SCH group. But there were no difference in the two SCH subgroups based on different TSH level. The results of correlation analysis showed that in all objects there were significant positive correlation between CP0, CP1 , CP2, CP3 and TSH, and there were negative correlation between FBG, PBG, HbAlc and TSH. In SCH group, there were no significant positive correlation between FBG, PBG, HbAlc, CP0, CP1, CP2, CP3 and TSH. Conclusion SCH can affect glucose metabolism, and became notable with the aggravation of SCH.
出处
《首都医科大学学报》
CAS
2008年第6期773-777,共5页
Journal of Capital Medical University
关键词
亚临床甲状腺功能减退
2型糖尿病
糖代谢
subclinical hypothyroidism
type 2 diabetes mellitus
glycometabolism
