摘要
目的探讨上海市松江区泗泾镇45岁以上的甲状腺功能状态和甲状腺激素水平与糖代谢状态之间的关系。方法2012年7月-2013年3月对上海市松江区泗泾镇所有社区〉45岁的居民进行糖代谢状态和甲状腺功能状态筛查。根据甲状腺功能检查结果，甲状腺功能状态分为甲状腺功能减退（HO）、亚临床甲状腺功能减退（SHO）、甲状腺功能正常（EU）、亚临床甲状腺功能亢进（SHE）、甲状腺功能亢进（HE）和甲状腺疾病史；根据空腹血糖和口服葡萄糖耐量试验结果，糖代谢状态分为血糖正常、单纯空腹血糖受损（IFG）、单纯糖耐量减低（IGT）、空腹和餐后血糖同时受损（CGI）、新诊断糖尿病和糖尿病史。结果最终纳入统计分析人数为4783名，男2160名，女2623名。男性中IFG患者的构成比显著高于女性（8．7％比6．4％，）[χ^2=8．747，P=0．003），IGT患者的构成比显著低于女性（13．9％比18．1％，χ^2=15．274，P〈0．001）。甲状腺功能异常者比例高达15．0％，其中最常见的为SH0（10．5％），女性中HO（1．7％比0．7％，χ^2=9．972，P=0．002）和SHO（13．0％比7．5％，χ^2=38．794，P〈0．001）患者的构成比显著高于男性。随着三碘甲状腺原氨酸（FT3）水平的升高，在男性中，血糖正常者（χ^2=0．047，P=0．045）和IFG者（χ^2=0．106，P=0．009）的构成比显著升高，IGT者（χ^2=0．072，P=0．031）和有糖尿病史者（χ^2=0．155，P=0．001）的构成比显著降低；在女性中，血糖正常者的构成比显著降低（χ^2=0．065，P=0．002），IFG者（χ^2=0．214，P〈0．001）和CGI者（χ^2=0．225，P〈0．001）的构成比显著升高。结论糖代谢状态分布和甲状腺功能状态分布都存在明显的性别差异。甲状腺激素水平显著影响血糖代谢状态。
Objective To explore the relationship between glucose metabolism and thyroid function in the residents aged more than 45 years in the Sijing District, Shanghai. Methods From July 2012 to March 2013, residents （〉45 years old） in Sijing District, Shanghai were invited to participate in a screening on thyroid function and glucose metabolism. According to the results of thyroid function tests, thyroid function statuses were divided into hypothyroidism （HO）, subclinical hypothyroidism （SHO）, euthyroidism （EU）, subclinical hyperthyroidism （SHE）, hyperthyroidism （HE） and a history of thyroid diseases. According to the results of fasting blood glucose and oral glucose tolerance test, glucose metabolic statuses were divided into normal glucose tolerance, impaired fasting glucose （IFG）, impaired glucose tolerance （IGT）, combined IFG and IGT （CGI）, newly-diagnosed diabetes and a history of diabetes. Results Eventually, 4 783 participants were enrolled in the statistic analysis, including 2 160 mates and 2 623 females. IFG was more prevalent in mates （8.7 % vs. 6.4%,χ^2 = 8. 747, P = 0. 003）,while IGT was more prevalent in females （13.9% vs. 18. 1%, χ^2= 15. 274, P〈0. 001）. The proportion of subjects with abnormal thyroid function was as high as 15, 0 %, and the most common one was SHO （10.5 % ）. HO （1.7% vs. 0.7%, χ^2=9.972, P = 0. 002） and SHO （13.0% vs. 7.5%,χ^2=38.794, P〈0. 001） were more prevalent in females. In males, the proportions of subjects with normal glucose tolerance （χ^2 = 0,047, P = 0. 045） and IFG （χ^2 = 0. 106, P = 0. 009） were increased with the increased level of triiodothyronine, while the proportions of subjects with IGT （χ^2 = -0. 072, P=0. 031） and a history of diabetes （χ^2 = -0. 155, P=0. 001） were decreased. In females, the proportion of subjects with normal glucose tolerance （χ^2 = - 0. 065, P =0. 002） were decreased with the increased level of triiodothyronine, while the proportions of subjects with IFG （χ^2= 0.214, P〈0.001） and CGI （χ^2 =0.225, P〈0.001） were increased. Conclusion Gender differences exist in the distribution of glucose metabolism status and thyroid function status. Thyroid hormone levels make significant contributions to different glucose metabolism statuses.
出处
《上海医学》
CAS
CSCD
北大核心
2016年第9期515-520,共6页
Shanghai Medical Journal
基金
国家自然科学基金资助项目(30305103
30800562)
关键词
甲状腺激素
糖尿病
糖耐量异常
空腹血糖受损
Thyroid hormones
Diabetes mellitus
Impaired glucose tolerance
Impaired fasting glucose
