2型糖尿病患者血清甲状腺激素水平的变化及意义

目的 探讨糖尿病患者血清甲状腺激素水平的变化及临床意义.方法 418例2型糖尿病患者,入院后行24 h动态血糖监测,计算平均血糖(MBG),测定空腹血糖(FPG)和血清C肽(FCP)、餐后2 h血糖(2hPG)和血清C肽(2hPCP)、糖化血红蛋白(HbA1c)、糖化血清蛋白(GA)及游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、反三碘甲状腺原氨酸(rT3)水平.按不同FPG水平分为FPG13.47 mmol/L、8.81且≤13.47 mmol/L和≤8.81 mmol/L组,按不同HbA1c水平分为<7%、≥7%且<10%、≥10%且<13%和≥13%组,比较各组间FT3、FT4、TSH、和rT3水平的差异.并分析影响甲状腺激素水平的主要因素.结果 FPG13.47 mmol/L、8.81且≤13.47 mmol/L组的FT3和rT3显著低于FPG≤8.81 mmol/L组(P值分别<0.01、0.05),FPG13.47 mmol/L组的TSH显著低于FPG≤8.81 mmol/L组(P<0.01).HbA1c≥7%且<10%、≥10%且<13%和≥13%组的FT3和TSH显著低于HbA1c<7%组(P值分别<0.01、0.05).FPG、MBG、HbA1c、AGE、GA的变化与FT3水平呈线性负相关(P<0.05),与rT3水平呈线性正相关(P<0.05).多元逐步回归分析发现,年龄是影响FT3和rT3变化的独立因素(OR=-0.061、0.004,P=0.00、0.001),FPG也是影响FT3和rT3变化的独立因素(OR=-0.012、0.19,p=-0.00、0.001).结论 甲状腺激素水平对糖尿病患者糖代谢的评估具有重要的临床意义.

Changes of serum thyroid hormones in type 2 diabetes patients and its clinical significance

Objective To investigate the variation of serum thyroid hormone in diabetes patients and its clinical significance.Methods A total of 418 diabetic patients were enrolled in this study. The mean blood glucose (MBG),hemoglobin Alc (HbAlc),glycated albumin (GA),and thyroid hormones free tri-iodothyronine (FT3),free thyroxine (FT4),revese-tri-iodothyronine (rT3),and thyroid stimulating hormone (TSH) were measured in each patient. The patients were divided into 3 groups according to the level of FPG:FPG>13.47 mm...