摘要
目的探讨2型糖尿病患者甲状腺功能变化的临床意义。方法选取122例2型糖尿病患者设为2型糖尿病组,另选取45例健康体检者作为对照组。将2型糖尿病组患者按照糖化血红蛋白(HbA1c)水平分为HbA1c<7%组(38例)、7%~10%组(42例)、HbA1c>10%组(42例)。比较2型糖尿病组与对照组空腹血糖(FBG)、HbA1c和甲状腺功能[促甲状腺激素(TSH)、游离三碘甲状原氨酸(FT3)、血清游离甲状腺素(FT4)]水平及2型糖尿病不同亚组的甲状腺功能和血脂[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)]水平。结果2型糖尿病组血清FT3(4.65±1.03)pmol/L、FT4(11.43±2.35)pmol/L和TSH(2.15±0.56)mU/L均明显低于对照组的(5.65±1.12)pmol/L、(13.46±2.32)pmol/L、(2.46±1.03)mU/L,FBG(10.47±2.23)mmol/L和HbA1c(8.45±2.32)%均明显高于对照组的(5.14±0.85)mmol/L、(4.14±1.35)%,差异有统计学意义(P<0.05)。HbA1c<7%组FT3为(5.52±0.94)pmol/L、FT4为(11.98±0.73)pmol/L、TSH为(2.45±0.87)mU/L、TC为(4.35±0.72)mmol/L、TG为(2.16±0.63)mmol/L、LDL-C为(2.74±0.56)mmol/L、HDL-C为(1.21±0.34)mmol/L;HbA1c 7%~10%组FT3为(4.93±0.85)pmol/L、FT4为(11.46±0.53)pmol/L、TSH为(2.34±0.65)mU/L、TC为(4.92±0.83)mmol/L、TG为(3.19±0.74)mmol/L、LDL-C为(3.19±0.64)mmol/L、HDL-C为(1.24±0.36)mmol/L;HbA1c>10%组FT3为(4.46±0.52)pmol/L、FT4为(11.23±0.26)pmol/L、TSH为(2.02±0.43)mU/L、TC为(5.64±0.92)mmol/L、TG为(3.47±0.86)mmol/L、LDL-C为(3.44±0.72)mmol/L、HDL-C为(1.29±0.42)mmol/L。随着HbA1c水平升高,血清FT3、FT4和TSH水平呈逐渐下降趋势,而血清TC、TG和LDL-C呈逐渐上升趋势。三组间FT3、FT4、TSH、TC、TG和LDL-C水平比较,差异有统计学意义(P<0.05);三组间HDL-C水平比较,差异无统计学意义(P>0.05)。结论2型糖尿病患者常伴有甲状腺功能异常,甲状腺激素水平的变化对于2型糖尿病患者的糖脂代谢有重要影响。
Objective To discuss the clinical significance of thyroid function changes in patients with type 2 diabetes mellitus.Methods 122 patients with type 2 diabetes mellitus were selected as type 2 diabetes mellitus group,and 45 healthy subjects were selected as control group.Patients with type 2 diabetes mellitus were divided into glycosylated hemoglobin(HbA1c)<7%group(38 cases),7%≤HbA1c≤10%group(42 cases)and HbA1c>10%group(42 cases)according to HbA1c level.Comparison was made on levels of fasting blood glucose(FBG),HbA1c and thyroid function[thyroid stimulating hormone(TSH),free triiodothyronine(FT3),serum free thyroxine(FT4)]in type 2 diabetes mellitus group and control group,as well as thyroid function and levels of blood lipid[total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)]in different subgroups of type 2 diabetes mellitus were compared.Results Type 2 diabetes mellitus group had serum FT3 of(4.65±1.03)pmol/L,FT4 of(11.43±2.35)pmol/L and TSH of(2.15±0.56)mU/L,which were significantly lower than those of(5.65±1.12)pmol/L,(13.46±2.32)pmol/L and(2.46±1.03)mU/L in the control group;FBG of(10.47±2.23)mmol/L and HbA1c of(8.45±2.32)%in type 2 diabetes mellitus group were significantly higher than those of(5.14±0.85)mmol/L and(4.14±1.35)%in the control group;the differences were statistically significant(P<0.05).In HbA1c<7%group,FT3 was(5.52±0.94)pmol/L,FT4 was(11.98±0.73)pmol/L,TSH was(2.45±0.87)mU/L,TC was(4.35±0.72)mmol/L,TG was(2.16±0.63)mmol/L,LDL-C was(2.74±0.56)mmol/L,and HDL-C was(1.21±0.34)mmol/L;in 7%≤HbA1c≤10%group,FT3 was(4.93±0.85)pmol/L,FT4 was(11.46±0.53)pmol/L,TSH was(2.34±0.65)mU/L,TC was(4.92±0.83)mmol/L,TG was(3.19±0.74)mmol/L,LDL-C was(3.19±0.64)mmol/L,and HDL-C was(1.24±0.36)mmol/L;in HbA1c>10%group,FT3 was(4.46±0.52)pmol/L,FT4 was(11.23±0.26)pmol/L,TSH was(2.02±0.43)mU/L,TC was(5.64±0.92)mmol/L,TG was(3.47±0.86)mmol/L,LDL-C was(3.44±0.72)mmol/L,and HDL-C was(1.29±0.42)mmol/L.With the increase of HbA1c level,serum FT3,FT4 and TSH levels were gradually decreased,while serum TC,TG and LDL-C were gradually increased.The levels of FT3,FT4,TSH,TC,TG and LDL-C among the three groups were compared,and the differences were not significantly significant(P<0.05).There was no statistically significant difference in HDL-C level among the three groups(P>0.05).Conclusion Patients with type 2 diabetes mellitus is often accompanied by abnormal thyroid function,the thyroid hormone level changes in patients with type 2 diabetes mellitus has an important influence on glucolipid metabolism.
作者
牛煊
NIU Xuan(Huanghe Sanmenxia Hospital,Sanmenxia 472000,China)
出处
《中国实用医药》
2023年第18期45-48,共4页
China Practical Medicine
关键词
2型糖尿病
甲状腺功能
糖化血红蛋白
血脂
Type 2 diabetes mellitus
Thyroid function
Glycosylated hemoglobin
Blood lipid
