亚临床甲状腺功能减退对2型糖尿病慢性并发症的影响

目的:探讨亚临床甲状腺功能减退(甲减)对糖尿病慢性并发症的影响。方法:将临床资料相对完整的1 062名2型糖尿病患者按照是否合并亚临床甲减分为亚临床甲减组及非亚临床甲减组,回顾性分析患者的一般资料、既往病史、合并慢性并发症、辅助检查结果及实验室检查指标,并进行多因素非条件Logistic回归分析。结果:合并亚临床甲减组患者的年龄、糖尿病病程、冠心病以及糖尿病慢性并发症发病率、空腹C肽、血脂、促甲状腺激素水平明显高于对照组,而ABI,E/A值低于单纯2型糖尿病组,经多因素非条件Logistic回归分析,发现高促甲状腺激素是糖尿病肾病(β=0.127 3,OR=1.136 1)、糖尿病足(β=0.115 3,OR=1.122 2)发生的独立危险因素。结论:2型糖尿病患者有必要定期进行甲状腺功能检查,以便及早诊断和干预亚临床甲减,从而预防和延缓糖尿病并发症的发生和发展。

Impact of Subclinical Hypothyroidism on Chronic Complications of Type 2 Diabetes

Objective: To study the impact of subclinical hypothyroidism(SCH) on chronic complications of type 2 diabetes.Methods: The clinical data of 1 062 cases of type 2 diabetes with or without SCH were studied,and the patient’s general information,medical history,chronic complications of diabetes,ancillary test and laboratory test results were analyzed.Multivariate unconditional logistic regressions were used to analyze the clinical data.Results: The age,duration of diabetes,incidence of coronary heart disease,chronic complications,etc.,and the levels of fasting C peptide,lipids and thyroid stimulating hormone(TSH) were significantly higher in diabetic patents with SCH than those without SCH,while the ankle brachial index(ABI) and E/A value were lower.Logistic regression analysis demonstrated that high level of TSH was an independent risk factor for diabetic nephropathy(β=0.127 3,OR=1.136 1) and diabetic foot(β=0.115 3,OR=1.222 2).Conclusion: For early diagnosis and intervention in subclinical hypothyroidism,thus for the preventing and delaying the development of diabetic complications,thyroid function should be regularly checked in type 2 diabetes patients.