摘要
背景亚临床甲状腺功能减退症（甲减）的发病率逐年升高,对代谢等多方面的影响越来越受到关注。目的探讨亚临床甲减居民血清25羟维生素D〔25（OH）D〕水平及心血管危险因素的变化及其相关性。方法从2009年11月—2010年2月贵阳市1 512例20~79岁社区居民的健康调查资料中,选取亚临床甲减居民202例为亚临床甲减组;同时选取性别、年龄匹配的甲状腺功能正常及甲状腺抗体阴性居民202例为对照组。所有受试者进行问卷调查、体格检查,并检测血糖、血脂、尿酸、尿碘、肌酐、血钙、血磷、空腹胰岛素（FINS）及25（OH）D、甲状旁腺激素（iPTH）、促甲状腺激素（TSH）、甲状腺过氧化物酶抗体（TPOAb）、甲状腺球蛋白抗体（TGAb）。结果亚临床甲减组居民舒张压、空腹血糖（FPG）、餐后2 h血糖（2 hPG）、三酰甘油（TG）、血磷、iPTH、TSH、TPOAb、TGAb均高于对照组,25（OH）D低于对照组,差异有统计学意义（P〈0.05）;TSH与收缩压、舒张压、2 hPG、TG呈正相关（P〈0.05）,与25（OH）D呈负相关（P〈0.05）。经校正性别、年龄、BMI后25（OH）D与TSH仍呈负相关（rs=-0.13,P〈0.01）。多元线性回归分析结果显示,腰围、25（OH）D、i PTH是亚临床甲减的影响因素（P〈0.05）。结论亚临床甲减居民可能存在维生素D的营养状况异常及多种心血管危险因素的异常。
Background Subclinical hypothyroidism morbidity has increased year by year,and its effects on metabolism have received more and more attention. Objective To investigate the changes of serum 25- hydroxy vitamin D 〔25（ OH） D〕level and cardiovascular risk factors in patients with subclinical hypothyroidism and their correlation. Methods Among the survey data of 1 512 community residents aged 20- 79 in Guiyang from November 2009 to February 2010,202 patients with subclinical hypothyroidism were selected as the subclinical hypothyroidism group; 202 patients with normal thyroid function and negative thyroid antibody of matched genders and ages were enrolled as the control group. Questionnaire survey,physical examination as well as the detection of blood glucose, blood lipids, uric acid, urine iodine, creatinine, blood calcium,blood phosphorus,fasting insulin（ FINS）,25（ OH） D,intact parathyroid hormone（ i PTH） and thyroid stimulating hormone（ TSH）, thyroid peroxidase antibody（ TPOAb） and thyroglobulin antibody（ TGAb） were given to all the subjects. Results The diastolic blood pressure, fasting plasma glucose（ FPG）, plasma glucose 2 hours after the meal（ 2 h PG）, triacylglycerol（ TG）, blood phosphorus, i PTH, TSH, TPOAb, and TGAb of residents in subclinical hypothyroidism group were significantly higher than those of the control group and 25（ OH） D of residents in subclinical hypothyroidism group was significantly lower than that of the control group（ P〈0. 05）; TSH was positively correlated with systolic pressure,diastolic pressure,2 h PG and TG（ P〈0. 05）,and negatively correlated with 25（ OH） D（ P〈0. 05）.After gender,age,and BMI correction,25（ OH） D was still negatively correlated with THS（ rs=- 0. 13,P〈0. 01）. The results of multiple linear regression analysis showed that waistline,25（ OH） D and i PTH were the influencing factors of subclinical hypothyroidism（ P〈0. 05）. Conclusion There may be abnormal nutritional status of vitamin D and cardiovascular risk factors in residents with subclinical hypothyroidism.
出处
《中国全科医学》
CAS
CSCD
北大核心
2016年第22期2671-2675,共5页
Chinese General Practice
基金
贵州省科技厅社会攻关计划(黔科合LG字[2011]016)--血清25羟维生素D水平与糖代谢紊乱的相关性研究
中华医学会临床医学科研专项资金(13050730458)--贵阳市城区成年人糖代谢异常人群与维生素D水平相关性的5年随访研究
