肥胖的非糖尿病患者胰岛素抵抗与促甲状腺激素水平的关系

目的评估肥胖的非糖尿病患者胰岛素抵抗(IR)与促甲状腺激素(TSH)水平之间的关系。方法选择2016年8月~2018年5月在扶风县人民医院内分泌科门诊接受治疗的肥胖的非糖尿病患者110例作为研究对象。收集所有患者的临床资料、实验室检查结果和甲状腺形态功能性评估结果。采用多元线性回归分析计算TSH水平与胰岛素抵抗指数(HOMA-IR)的关系。结果在整个队列中,TSH水平与HOMA-IR(r=0.24,P=0.028)、血清胰岛素(r=0.23,P=0.037)和甘油三酯水平(r= 0.30,P=0.006)均呈正相关,而与血清高密度脂蛋白胆固醇(HDL-C)水平呈负相关(r=-0.25,P=0.002)。HOMA-IR与甘油三酯(r=0.25,P=0.026)、ALT(r=0.37,P=0.001)和γ谷氨酰转肽酶(r=0.32,P=0.003)水平均呈正相关。多元线性回归分析结果显示,TSH(β=0.620,95%CI 0.482~0.758,P=0.015)、BMI(β=0.147,95%CI 0.111~0.184,P=0.034)均与HOMA-IR显著相关。结论 TSH与肥胖的非糖尿病患者出现胰岛素抵抗相关,表明甲状腺功能筛查对肥胖患者较为重要。

Relationship between insulin resistance and thyroid stimulating hormone level in obese non-diabetic patients

Objective To evaluate the relationship between thyroid stimulating hormone(TSH) level and insulin resistance(IR) in obese non-diabetic patients.Methods Obese non-diabetic patients who were treated in the clinic of endocrinology department in people’s hospital of Fufeng county from August 2016 to May 2018 were selected as subjects.The clinical data,laboratory results and thyroid morphological and functional evaluation results were collected.The relationship of TSH level and insulin resistance index(HOMA-IR) were computed using multivariate linear regression analysis.ResultsTSH level was positively correlated with HOMA-IR(r=0.24,P=0.028),serum insulin(r=0.23,P=0.037)and triglyceride(r=0.30,P=0.006)in the overall cohort,while negatively correlated with serum high density lipoprotein cholesterol(r=-0.25,P=0.002).HOMA-IR was positively correlated with triglyceride(r=0.25,P=0.026),ALT(r=0.37,P=0.001)and amplification of glutamyl transpeptidase(r=0.32,P=0.003).The results of multivariate linear regression analysis showed that TSH(β=0.620,95%CI0.482-0.758,P=0.015)and BMI(β=0.147,95%CI0.111-0.184,P=0.034)were significantly correlated with HOMA-IR.Conclusion TSH is associated with insulin resistance in obese non-diabetic patients,suggesting that the screening of thyroid function is important for obese non-diabetic patients.