肥胖对2型糖尿病患者甲状腺功能的影响研究

目的 探讨肥胖对2型糖尿患者甲状腺功能的影响.方法 选取2010年我院内分泌科初诊2型糖尿病患者,测量体重、身高,计算体重指数(BMI).选择BMI正常者(对照组,BMI 18.5～23.9 kg/m2)和肥胖者(肥胖组,BMI≥28.0 kg/m2)为研究对象.采用化学发光法,分别检测两组的甲状腺功能甲状腺素(T4)、血清三碘甲状腺原氨酸(T3)、游离甲状腺素(FT4)、促甲状腺素(TSH)、游离三碘甲状腺原氨酸(FT3)]及甲状腺自身抗体抗甲状腺过氧化物酶抗体(aTPO)、抗甲状腺球蛋白抗体(aTG)]水平,同时收集空腹血糖、糖化血红蛋白(HbA1c)、血脂等相关临床资料.对比分析两组患者上述指标间的差异及影响因素.结果 肥胖组患者T3水平(89±19)ng/dl较对照组(128±21)ng/dl显著降低,肥胖组患者aTPO(92±186)U/ml较对照组(51±137)U/ml显著升高,差异均有统计学意义(P＜0.05).Spearman相关分析结果显示:T3水平与TSH、BMI、空腹血糖水平呈负相关(P＜0.05).aTPO与aTG呈正相关(P＜0.05).结论 肥胖2型糖尿病患者甲状腺功能及甲状腺自身抗体已有改变,表现为T3水平下降,aTPO水平升高.aTPO与aTG呈相关性.

Influence of obesity on thyroid function of patients with type 2 diabetes

Objective To discuss the influence of obesity on the thyroid function of patients with type 2 diabetes. Methods Patients in our hospital, who were preliminarily diagnosed as type 2 diabetes in 2010, were selected to get their weight and height measured. After their body mass indexes （BMI）were calculated, those with normal BMI were selected as control group （BMI 18.5 - 23.9 kg/m2 ） and the obese ones were chosen as obesity group （ BMI/〉 28.0 kg/m2 ）. The method of chemiluminescence was used to examine the thyroid function of the two groups （ T4, T3, FT4, TSH and FF3 ） and the level of thyroid autoantibody （ aTPO and aTG）. Meanwhile the clinical data of their fasting blood glucose, glycosylated hemoglobin （ HbAlc ） and blood fat were collected. The differences in above indexes between the two groups were compared and analyzed. Results The T3 level of the obesity group obviously decreased compared with that of the control group （89 ± 19）ng/dl and（ 128 ± 21 ）ng/dl]. Compared with aTPO of the control group, that of the obesity group significantly increased （92 ± 186 ） U/ml versus （ 51 ± 137 ） U/ml ]. All of these differences were significant （P 〈 0.05 ）. The Spearman analysis showed that there were negative correlations between T3 and TSH, BMI ,fasting blood glucose level （P 〈 0.05 ）, and there was a positive correlation between aTPO and aTG （ P 〈 0.05 ）. Conclusion The thyroid function and thyroid autoantibody level changes in obese patients with type 2 diabetes whose T3 level decreases and aTPO level increases. There is a significant correlation between aTPO and aTG.