老年2型糖尿病病人甲状腺激素的变化及相关因素分析

doi:10.3969/j.issn.1006-7795.2017.02.006

摘要/Abstract

摘要： 目的探讨老年2型糖尿病病人甲状腺激素的变化，分析其临床意义及相关危险因素。方法该病例-对照研究采用数字表法随机入选到医院就诊的140例老年2型糖尿病（type 2 diabetes mellitus，T2DM）病人为病例组，同期体检的147例非糖尿病健康老人为对照组，静脉采血化验促甲状腺素（thyroid-stimulating hormone，TSH）、三碘甲状腺原氨酸（triiodothyronine，T3）、四碘甲状腺原氨酸（thyroxine，T4）、甲状腺过氧化物酶抗体（anti-thyroid peroxidase antibody，TPOAb）、甲状腺球蛋白抗体（anti-thyroglobulin antibody，TGAb）、促甲状腺素受体抗体（thyroid-stimulating hormone receptor antibodies，TRAb），检测甲状腺彩超，选取以上检查均正常者入选本研究。病例组还需化验空腹血糖（fasting plasma glucose，FPG）、糖化血红蛋白（glycosylated hemoglobin A1c，HbA1c），根据年龄、病程、FPG及HbA1c不同分为若干组分。比较病例组与对照组以及病例组各组间甲状腺激素的变化，分析其相关危险因素。结果 ①与对照组相比，病例组T3降低，差异有统计学意义（P<0.05）。②随着老年糖尿病病人年龄增长、病程延长、FPG及HbA1c的升高，病例组各组间T3呈下降趋势，差异有统计学意义（P<0.05）。③相关回归分析显示，病例组T3与年龄、病程、FPG、HbA1c呈线性负相关。病程、HbA1c是影响T3的独立危险因素。结论老年糖尿病病人的T3已有不同程度的降低，糖尿病病人甲状腺激素浓度的测定可反映其糖代谢紊乱程度。

关键词: 老年人, 糖尿病, 甲状腺激素

Abstract: Objective To investigate the changes of serum thyroid hormone in elderly patients with type 2 diabetes mellitus (T2DM) and relevant factors. Methods According to the random number method,140 elderly patients with T2DM admitted into our hospital were assigned to the case group, and 147 healthy persons without diabetes in the same period were assigned to the control group. The thyroid-stimulating hormone(TSH),triiodothyronine(T3), thyronine (T4),anti-thyroid peroxidase antibody (TPOAb), anti-thyroglobulin antibody (TGAb) and thyroid-stimulating hormone receptor antibodies(TRAb) were assayed. Thyroid color Dopplar ultrasonography was performed. Fasting plasma glucose (FPG), glycosylated hemoglobin A1c (HbA1c) were additionally given for T2DM patients. The patients were divided into several groups according to their age、duration、FPG and HbA1c levels.The difference of thyroid hormone levels in each group and impact factors to thyroid hormones in T2DM patents were analyzed. Results ①Compared with control group, the level of T3 in the case group were significantly lower(P<0.05). ②With the increase of age、duration of diabetes、FPG and HbA1c level in the erlderly patients with diabetes,the level of T3 were significantly decreased(P<0.05).③In the case group, T3 was negatively correlated with age, duration of diabetes, FPG and HbA1c. Duration of diabetes and HbA1c were the independent factors influencing the changes of T3. Conclusion Thyroid hormones level in elderly patients with T2DM reflects the degree of glucose metabolism disorder.

Key words: elderly, diabetes, thyroid hormones

中图分类号:

R587.1

马娜敏, 王敏, 聂圆圆, 于世林, 耿亚辉, 董建全, 袁梅英, 杨金奎. 老年2型糖尿病病人甲状腺激素的变化及相关因素分析[J]. 首都医科大学学报, 2017, 38(2): 172-177.

Ma Namin, Wang Min, Nie Yuanyuan, Yu Shilin, Geng Yahui, Dong Jianquan, Yuan Meiying, Yang Jinkui. Correlation between serum vitamin D level and thyroid function and clinical characteristics in the newly-diagnosed type 2 diabetes mellitus patients[J]. Journal of Capital Medical University, 2017, 38(2): 172-177.

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