甲状腺功能正常绝经后女性血TSH水平与胰岛素抵抗及代谢综合征的关系

目的观察甲状腺功能正常的绝经后女性血清促甲状腺激素（TSH）水平与胰岛素抵抗（IR）、代谢综合征（MS）的关系。方法2012年6—12月，从我院查体中心查体人群中随机抽取279例甲状腺功能正常的绝经后女性，按TSH水平分为高TSH组（73例）和低TSH组（206例），比较两组IR程度和MS及其主要组分的检出率。MS诊断符合改良的2005年国际糖尿病联盟标准。结果两组间FT3、FT4水平差异无显著性（P〉0．05）；与低TSH组相比，高TSH组病人血浆胰岛素水平和IR指数显著增高，而胰岛素敏感指数显著降低（t=1．971～2．642，P〈0．05）；与低TSH组相比，高TSH组体质量超标或肥胖、MS检出率显著增高（x^2=3．893、3．856，P〈0．05）；高血压、高糖血症、高三酰甘油血症和低高密度脂蛋白胆固醇血症检出率有增高趋势，但差异无统计学意义（P〉0．05）。结论绝经后女性血清TSH水平与IR、MS密切相关。即使在正常参考值范围内，当TSH〉2．5mU／L时，应对绝经后女性MS及其主要组分进行评估。

ASSOCIATION BETWEEN SERUM LEVELS OF THYROID STIMULATING HORMONE AND INSUNLIN RESISTENCE AND METABOLIC SYNDROME IN EUTHYROID POSTMENOPAUSAL WOMEN

Objective To observe the relationship between serum levels of thyroid stimulating hormone CTSH） and insunlin resistence OR） and metabolic syndrome C MS） in euthyroid postmenopausal women. Methods During June to December of 2012,279 euthyroid postmenopausal women were selected from Physical Examination Center of our hospital, who were divided into high-Or = 73） and low- TSH groups （n = 206） based on the levels of TSH. The extent of IR between the two groups, and MS and the detection rates of its key components were compared. The diagnosis of MS met the modified 200S International Diabetes Federation criteria. Results There were no significant differences in serum levels of both FT3 and FT4 between the two groups （P〉O.OS）. Compared with low-TSH group, the plasma levels of insulin and HOMA-IR in high-TSH group were significantly higher and insulin sensitivity index was significantly lower （t = 1. 971 - 2.642, P 〈O.05）, and the detection rate of overweight or obesity and MS was significantly increased （x^2 = 3.893, 3.8S6; P〈0.05）. There was a tendency of increased detection rate of hypertension, hyperglycemia, hypertriglyceridemia and low serum of HDLC. Conclusion Serum level of TSH is closely related with IR and metabolic syndrome, when TSH level is higher than 2.5 m Uv L, even though within normal reference values, an assessment for metabolic syndrome and its main components should be made in postmenopausal women.