1型糖尿病合并甲状腺自身免疫紊乱临床特征分析

目的探讨1型糖尿病（T1DM）患者合并甲状腺自身免疫紊乱的发生情况。方法对98例（T1DM）、98例2型糖尿病（T2DM）患者、98例健康对照者进行甲状腺过氧化物酶抗体（TPO-Ab）、甲状腺球蛋白抗体（TG-Ab）、促甲状腺激素受体抗体（TR-Ab）检测,糖尿病患者同时加测谷氨酸脱羧酶抗体（GAD-Ab）及超敏TSH（uTSH）,uTSH异常者加测游离T3（FT3）、游离T（4FT4）。测定数据经统计学处理、比较。结果 T1DM任一甲状腺抗体（TAA）的检出率为36.7%,明显高于T2DM（10.2%）和对照组（9.2%）,差别有统计学意义。GAD-Ab阳性的T1DM患者任一TAA的检出率为43.5%,明显高于GAD-Ab阴性者（27.6%）,差别有统计学意义。TAA阳性及GAD-Ab阳性的患者中,女性比例明显增加。结论 GAD-Ab阳性和女性T1DM患者易合并甲状腺自身免疫紊乱。

Analysis of clinical features in type 1 diabetic patients with thyroid autoimmunity

Objective To investigate the prevalence of thyroid autoimmunity in type 1 diabetics(T1DM).Methods The frequencies of thyroperoxidase antibodies(TPO-Ab),thyroglobulin antibodies(TG-Ab) and TSH receptor antibodies(TR-Ab) were determinded in 294 subjects,including 98 T1DM,98 type 2 diabetics(T2DM) and 98 controls.Glutamic acid decarboxylase antibody(GAD-Ab)and supersensitivity thyroid stimulating hormone(uTSH) were measured in T1DM and T2DM.The patients with uTSH positive were measured free T3(FT3) and free T4(FT4).Measured data were statistically analyzed.Results Thyroid autoantibody existed more frequently in T1DM than that in T2DM and control.The TAA positive patients were increased in T1DM with GAD-Ab than those without it.The proportion of female in patients with positive TAA or positve GAD-Ab was markedly increased.Conclusion Patients with GAD-Ab positive or female in T1DM have the higher risks for thyriod autoimmunity.