摘要
目的:探讨糖化血红蛋白(HbA1c)与DM2患者甲状腺激素和胆红素之间的关系。方法:测定162例DM2患者的HbA1c、超敏促甲状腺素(hs-TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、总胆红素(TBIL)、直接胆红素(DBIL),计算出间接胆红素(NDBIL)水平。按不同的HbA1c水平将患者分为血糖控制良好、血糖控制较差和血糖控制差三组,比较各组间甲状腺激素和胆红素的差异,并分析HbA1c与甲状腺激素及胆红素的相关性。结果:血糖控制较差组的hs-TSH、TBIL和NDBIL的水平显著低于血糖控制良好组(P值均<0.05);血糖控制差组的hs-TSH、FT3、TBIL和NDBIL的水平显著低于血糖控制良好组(P值分别<0.01、<0.05、<0.01、<0.01);血糖控制差组的FT3水平显著低于血糖控制较差组(P值<0.01);而FT4和DBIL三组间没有统计学意义(P值均>0.05)。HbA1c与hs-TSH、FT3、TBIL、NDBIL呈显著负相关,Pearson相关系数分别为-0.286、-0.259、-0.157、-0.168(P值分别为<0.01、<0.01、<0.05、<0.05),HbA1c与FT4、DBIL无相关,Pearson相关系数分别为0.110、-0.101,P均>0.05。结论:HbA1c对DM2患者的甲状腺激素和胆红素水平有影响。测定HbA1c、甲状腺激素和胆红素水平,对于糖尿病患者糖代谢的评估、病情的控制和预后的判断具有重要的临床意义。
Objective To study the changes of serum thyroid hormones and bilirubin levels in DM2 patients with different serum HbA1c comcentrations.Methods Serum hs-TSH,FT3,FT4（with CLIA） total,direct and indirect bilirubin and HbA1c （with biochemistry） levels were determined in 162 patients with DM2.These 162 DM2 patients were of three groups： ① Group A： hyperglycemia well controlled,HbA1c≤7% n = 37 ② Group B： hyperglycemia controlled less than satisfactory,7% HbA1c 10% ,n = 63 ③ Group C： hyperglycemia poorly controlled,HbA1c≥10% ,n = 62.Results Serum hs-TSH,direct and indirect bilirubin levels in Group B DM2 patients were significantly lower than those in Group A patients （all P 〈0.05） .The levels of hs-TSH,FT3,total and indirect bilirubin in Group C patients were significantly lower than those in Group A patients （P 〈0.01, 0.05, 0.01, 0.01 respectively） .The serum FT3 levels in Group C patients were significantly lower than those in Group B patients （P 〈0.01） .However,the serum levels of FT4 and direct bilirubin were not significantly different among the three groups （all P 〈0.05） .Serum HbA1c levels were significantly negatively correlated with serum hs-TSH,FT3 total and indirect bilirubin （r =-0.286,-0.259,-0.157,-0.168,P 〈0.01, 0.01, 0.05, 0.05 respectively） ,but were not correlated with serum FT4 and direct bilirubin levels （r = 0.110,0.101,P 〈0.05, 0.05 respectively） .Conclusion Serum thyroid hormones and bilirubin levels were much lower in DM2 patients with not well controlled as shown by the much higher HbA1c values.Determination of these parameters might be of help for assessment of general condition of the DM2 patients.
出处
《放射免疫学杂志》
CAS
2010年第5期555-557,共3页
Journal of Radioimmanology
