2型糖尿病患者合并甲状腺功能异常的临床特点分析

目的分析2型糖尿病患者中不同类型甲状腺功能异常的患病率和临床特点。方法对215例2型糖尿病患者的临床资料进行回顾性分析。甲状腺功能状态分为临床甲状腺功能减退(简称甲减)促甲状腺激素(TSH)4.2 m U/L和游离甲状腺素(FT4)9.3 ng/L,亚临床甲状腺功能减退(简称亚甲减)TSH4.2m U/L和FT4 9.3~17 ng/L,临床甲状腺功能亢进(简称甲亢)TSH0.27 m U/L和FT41.7 m U/L,亚临床甲状腺功能亢进(亚甲亢)TSH0.27 m U/L和FT4 9.3~17 ng/L。比较不同类型甲状腺功能异常之间年龄、性别、动脉硬化和生化指标的变化。结果亚临床甲减患病率最高为4.6%,临床甲亢患病率最低,为0.9%,临床甲减及亚临床甲亢的患病率分别为3.7%、1.3%。甲减组年龄、三酰甘油和动脉硬化患病率较甲亢组和正常组明显升高,差异有统计学意义,性别和胆固醇差异无统计学意义。甲亢组空腹及餐后血糖均较甲减组和正常组明显升高,差异有统计学意义。结论 2型糖尿病患者甲状腺功能异常患病率高,特别是亚临床功能异常,而大多数人可无症状但对糖脂代谢存在不良影响,并增加动脉硬化风险。

Analysis of clinical characteristics of patients with type 2 diabetes mellitus complicated with thyroid dysfunction

Objective To analyze case rate and clinical characteristics of different types of thyroid dysfunction in patients with type 2 diabetes mellitus.Methods The clinical data of 215 patients with type 2 diabetes mellitus were retrospectively analyzed.Thyroid function includes four kinds:hypothyroidism with TSH>4.2 mU/L and FT4<9.3 ng/L;subclinical hypothyroidism with TSH>4.2 mU/L and FT4 9.3-17 ng/L;hyperthyroidism with TSH<0.27 mU/L and FT4>1.7 mU/L;subclinical hyperthyroidism with TSH<0.27 mU/L and FT4 9.3-17 ng/L.The age,sex,arteriosclerosis and biochemical changes between different types of thyroid dysfunction were compared.Results The case rate of subclinical hypothyroidism was 4.6%,which was the highest and the case rate of hyperthyroidism was 0.9%,which was the lowest.The case rate of hypothyroidism and subclinical hyperthyroidism was respectively 3.7% and 1.3%.The age,TG and case rate of arteriosclerosis in hypothyroidism group were significantly higher than those in hyperthyroidism and normal group and the difference was statistically significant.There was no statistically significant difference in sex and cholesterol.Both FBG and PBG of hyperthyroidism group were significantly higher than those of hypothyroidism group and normal group and the difference was statistically significant.Conclusion The case rate of thyroid dyfunction in type 2 diabetes mellitus is high,especially subclinical dysfunction.And most of people have no symptoms but it can exercise adverse effects on their glucose and lipid metabolism and increase the risk of arteriosclerosis.