亚临床甲状腺功能减退症与糖尿病下肢动脉病变的关系研究

doi:10.3969/j.issn.1006-7795.2018.04.008

首都医科大学学报 ›› 2018, Vol. 39 ›› Issue (4): 522-526.doi: 10.3969/j.issn.1006-7795.2018.04.008

• 糖尿病合并症的基础与临床研究 • 上一篇下一篇

亚临床甲状腺功能减退症与糖尿病下肢动脉病变的关系研究

张琳¹, 袁明霞¹, 杨光燃¹, 刘薇¹, 谢荣荣², 杜燕芳¹, 杨金奎^1,2

1. 首都医科大学附属北京同仁医院内分泌科, 北京 100730;
2. 糖尿病防治研究北京市重点实验室, 北京 100730

收稿日期:2018-06-04 出版日期:2018-07-21 发布日期:2018-07-21
通讯作者: 杨金奎 E-mail:jkyang@ccmu.edu.cn
基金资助:
国家自然科学基金（81471009），首都全科医学研究专项课题（1172338615），首都医科大学基础临床合作研究基金（14JL46）。

Association between subclinical hypothyroidism and lower extremity arterial disease in male patients with diabetes mellitus

Zhang Lin¹, Yuan Mingxia¹, Yang Guangran¹, Liu Wei¹, Xie Rongrong², Du Yanfang¹, Yang Jinkui^1,2

1. Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China;
2. Beijing Key Laboratory of Diabetes Research and Care, Beijing 100730, China

Received:2018-06-04 Online:2018-07-21 Published:2018-07-21
Supported by:
This study was supported by National Natural Science Foundation of China(81471009), Special Subjects of General Medical Research in the Capital(1172338615), Foundation for Basic Clinical Cooperation Research of Capital Medical University (14JL46).

摘要/Abstract

摘要： 目的探讨亚临床甲状腺功能减退症（subclinical hypothyroidism，SCH）与2型糖尿病下肢动脉病变（lower extremity arterial disease，LEAD）的关系。方法选择首都医科大学附属北京同仁医院内分泌科住院的2型糖尿病患者746例，测定所有患者甲状腺功能和踝肱指数（ankle brachial index，ABI），根据ABI分为糖尿病合并LEAD组和对照组，比较两组患者基本情况、生物化学指标和SCH的患病率。采用单因素和多因素Logistic回归分析糖尿病下肢动脉病变的危险因素。结果 746例2型糖尿病患者中，117例合并SCH，女性患病率高于男性（P<0.05）。LEAD组患者促甲状腺激素（thyroid stimulating hormone，TSH）浓度及SCH患病率较对照组升高。Logistic回归分析显示，年龄（OR=1.055，95% CI：1.031~1.078，P<0.001），SCH（OR=2.162，95% CI：1.383~3.379，P=0.001），吸烟（OR=2.129，95% CI：1.352~3.355，P=0.001），收缩压（OR=1.014，95% CI：1.004~1.023，P=0.005），低密度脂蛋白胆固醇（OR=1.189，95% CI：1.026~1.378，P=0.021）与糖尿病LEAD正相关，总肾小球滤过率下降（OR=0.984，95% CI：0.974~0.995，P=0.003）与LEAD负相关。男性患者中，SCH对LEAD的影响更显著（OR=3.747，95% CI：1.940~7.239，P<0.001），女性患者中则无相关性。结论 SCH与男性2型糖尿病患者LEAD密切相关。

关键词: 亚临床甲状腺功能减退症, 2型糖尿病, 下肢动脉病变, 踝肱指数

Abstract: Objective To investigate the relationship between subclinical hypothyroidism (SCH) and lower extremity arterial disease(LEAD) in patients with type 2 diabetes. Methods Totally 746 patients with type 2 diabetes hospitalized in the Department of Endocrinology of Beijing Tongren Hospital, Capital Medical University were selected. The thyroid function and ankle brachial index (ABI)were examined in all patients. And then diabetic patients were divided into two groups with and without LEAD according to ABI. The basic situation, biochemical indexes and SCH prevalence rate of the two groups were compared. Univariate and multivariate Logistic regression analysis was used to analyze the risk factors of diabetic LEAD. Results 117 cases combined with SCH and the prevalence rate among women was significantly higher than that among men(P<0.05)in these 746 patients with type 2 diabetes. The level of thyroid stimulating hormone (TSH) and the prevalence of SCH in the LEAD group were higher than those in the control group. Logistic regression analysis showed that age (OR, 1.055,95% CI:1.031-1.078, P<0.001), SCH (OR, 2.162, 95% CI:1.383-3.379, P=0.001), smoking(OR, 2.129,95% CI:1.352-3.355, P=0.001), systolic blood pressure (OR, 1.014,95% CI:1.004-1.023, P=0.005), low density lipoprotein (OR, 1.189,95% CI:1.026-1.378, P=0.021)was positively correlated with LEAD, and total glomerular filtration rate (OR, 0.984,95% CI:0. 974-0.995, P=0.003)was negatively correlated with LEAD. In male patients, SCH had a more significant effect on LEAD (OR, 3.747,95% CI:1.940-7.239, P<0.001), but no correlation was found in female patients. Conclusion The results suggested a closed association between SCH and LEAD in male patients with type 2 diabetes mellitus.

Key words: subclinical hypothyroidism, type 2 diabetes, lower extremity arterial disease, ankle brachial index

中图分类号:

张琳, 袁明霞, 杨光燃, 刘薇, 谢荣荣, 杜燕芳, 杨金奎. 亚临床甲状腺功能减退症与糖尿病下肢动脉病变的关系研究[J]. 首都医科大学学报, 2018, 39(4): 522-526.

Zhang Lin, Yuan Mingxia, Yang Guangran, Liu Wei, Xie Rongrong, Du Yanfang, Yang Jinkui. Association between subclinical hypothyroidism and lower extremity arterial disease in male patients with diabetes mellitus[J]. Journal of Capital Medical University, 2018, 39(4): 522-526.

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亚临床甲状腺功能减退症与糖尿病下肢动脉病变的关系研究

Association between subclinical hypothyroidism and lower extremity arterial disease in male patients with diabetes mellitus

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