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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

29卷

期数:

2023年05期

页码:

466-471

栏目:

内分泌疾病专题

出版日期:

2023-09-20

文章信息/Info

Title:

Association between thyroid hormone levels and chronic complications in euthyroid patients with type 2 diabetes mellitus

文章编号:

1006-8147（2023）05-0466-06

作者:

任亚女; 董作亮; 罗慧景; 张靓男; 胡志东

（天津医科大学总医院医学检验科，天津300052）

Author(s):

REN Ya-nyu; DONG Zuo-liang; LUO Hui-jing; ZHANG Liang-nan; HU Zhi-dong

（Department of Clinical Laboratory，General Hospital，Tianjin Medical University，Tianjin 300052，China）

关键词:

甲状腺激素; 糖尿病; 2型; 慢性并发症

Keywords:

thyroid hormone; diabetes mellitus; type 2; chronic complication

分类号:

R587.1

DOI:

-

文献标志码:

A

摘要:

目的：探讨甲状腺功能正常的2型糖尿病（T2DM）患者甲状腺激素（TH）水平与慢性并发症的相关性。方法：选取400例甲状腺功能正常且长期在天津居住的T2DM患者作为研究对象。根据是否合并慢性并发症，分为T2DM合并慢性并发症组（T2DM+C组）（n=261）和单纯T2DM组（T2DM组）（n=139）；根据合并的慢性并发症，分为糖尿病肾病组（DKD组）（n=111）、糖尿病视网膜病变组（DR组）（n=129）、糖尿病周围神经病变组（DPN组）（n=121）和心血管疾病组（CVD组）（n=200），收集患者的临床资料及检测指标数据，将有差异的结果纳入受试者工作特征（ROC）曲线分析。结果：与T2DM组比，T2DM+C组FT3水平降低，高血压患病率、糖尿病（DM）病程、年龄、体重指数（BMI）、尿素（UREA）、尿白蛋白与肌酐比值（ACR）升高；DKD组FT3水平降低，高血压患病率、吸烟率、年龄、BMI、DM病程、UREA、肌酐（CREA）、ACR升高；DR组FT3水平降低，高血压患病率、年龄、BMI、DM病程、ACR升高；DPN组FT3、血脂异常率降低，高血压患病率、年龄、DM病程、UREA、ACR升高；CVD组FT3、FT4水平降低，高血压患病率、年龄、DM病程、UREA、CREA、ACR升高（均P<0.05）。二元Logistic回归分析，FT3降低、ACR升高及DM病程增加与T2DM患者发生DKD、DR、DPN、CVD高风险相关，高血压患病率升高也与发生DPN高风险相关（均P<0.05）。ROC曲线分析显示，FT3单独预测DKD、DR、DPN及CVD的曲线下面积（AUC）为0.756、0.746、0.785、0.783，与DM病程联合预测AUC为0.818、0.830、0.880、0.855。结论：甲状腺功能正常的T2DM慢性并发症患者FT3水平降低，FT3单独预测T2DM慢性并发症的发生有一定的应用价值，与DM病程联合预测效果更佳。

Abstract:

Objective： To investigate the relationship between thyroid hormone（TH） level and chronic complications in euthyroid subjects with type 2 diabetes mellitus（T2DM）. Methods：A total of 400 T2DM patients with normal thyroid function and long-residence in Tianjin were selected as the study subjects. According to whether there were chronic complications，the patients were divided into T2DM with chronic complications group（T2DM+C group）（n=261） and simple T2DM group（T2DM group）（n=139）.According to the chronic complications，they were divided into diabetic kidney disease group（DKD group）（n=111），diabetic retinopathy group （DR group）（n=129），diabetic peripheral neuropathy group（DPN group）（n=121） and cardiovascular disease group（CVD group）（n=200）. Clinical data and detection indicators of patients were collected，the results with differences were included in the subject operating characteristic curve （ROC） analysis. Results：Compared with T2DM group，FT3 level was decreased in T2DM+C group，and rate of hypertension，duration of DM，age，BMI，UREA，urinary albumin to creatinine ratio（ACR） were increased；FT3 level was decreased in DKD group，and rate of hypertension，smoking rate，age，BMI，duration of DM，UREA，CREA and ACR were increased; FT3 level was decreased in DR group，and rate of hypertension，age，BMI，duration of DM and ACR were increased; FT3 level and dyslipidemia were decreased in DPN group，and rate of hypertension，age，duration of DM，UREA and ACR were increased; FT3 and FT4 levels were decreased in CVD group，and rate of hypertension，age，duration of DM，UREA，CREA and ACR were increased（all P<0.05）. Binary Logistic regression analysis showed that the decrease of FT3，the increase of ACR and duration of DM were correlated with the high risk of DKD，DR，DPN and CVD in T2DM patients and the high prevalence of hypertension was correlated with the high risk of DPN（all P<0.05）. ROC curve analysis showed that the AUC of DKD，DR，DPN and CVD predicted by FT3 were 0.756，0.746，0.785 and 0.783. The AUC of FT3 combined with duration of DM to predict DKD，DR，DPN and CVD were 0.818，0.830，0.880 and 0.885. Conclusion：FT3 levels are decreased in patients in euthyroid subjects of T2DM with chronic complications. FT3 alone has a certain application value in predicting the occurrence of chronic complications of T2DM，and the combination prediction effect with the duration of DM is better.

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备注/Memo

备注/Memo:

作者简介 任亚女（1989-），女，主管技师，硕士在读，研究方向：内分泌学；通信作者：胡志东，E-mail：huzhidong 27@163.com。

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更新日期/Last Update: 2023-09-25