2型糖尿病合并不同水平高血压患者甲状腺激素水平变化及其相关性研究

发布时间：2018-08-31 10:35

【摘要】：目的观察2型糖尿病(T2DM)合并不同水平高血压患者甲状腺激素水平的变化,并探讨其相关因素。方法选取T2DM合并高血压患者392例,根据血压水平分为正常血压组135例、高血压1级组107例、高血压2级组89例及高血压3级组61例。测定各组甲状腺激素水平,包括游离三碘甲状腺原氨酸(FT3)、游离甲状腺激素(FT4)及促甲状腺激素(TSH),并采用Pearson相关分析和多元逐步回归分析指标间的相关性。结果(1)随高血压水平升高,各组TSH水平升高[0.42(0.22~0.88)vs 0.80(0.33~1.01)vs 1.45(0.97~2.11)vs 2.75(2.10~4.20)m IU/L]、FT3水平降低[(5.31±0.54)vs(4.79±0.66)vs(4.47±0.52)vs(3.51±0.30)pmol/L](P0.05),而各组间FT4水平比较,差异无统计学意义[(16.26±2.71)vs(16.04±2.75)vs(15.39±3.41)vs(16.30±2.70)pmol/L](P0.05);(2)Pearson相关分析发现,FT3与高血压分级和年龄呈负相关(r=-0.408和-0.194,P=0.000和0.042);FT4与TG呈负相关,与HDL-C呈正相关(r=-0.227和0.189,P=0.028和0.046),与高血压分级无相关性(r=0.017,P=0.463);TSH与高血压分级、BMI、TG、TC、LDL-C及SUA呈正相关(r=0.357、0.196、0.277、0.123、0.214和0.342,P=0.005、0.041、0.025、0.046、0.020和0.001),与Hb A1c呈负相关(r=-0.222,P=0.034);(3)多元逐步回归分析发现,高血压分级和年龄为FT3的影响因素(均P=0.00);高血压分级和SUA为TSH的影响因素(均P=0.00);FT4未发现影响因素。结论随着血压水平的升高,TSH水平升高、FT3水平降低及FT4水平无变化;高血压分级是FT3和TSH的影响因素。
[Abstract]:Objective to observe the changes of thyroid hormone levels in patients with type 2 diabetes mellitus (T2DM) and hypertension. Methods 392 T2DM patients with hypertension were divided into normal blood pressure group (n = 135), hypertension grade 1 group (n = 107), hypertension grade 2 group (n = 89) and hypertension grade 3 group (n = 61). The levels of thyroid hormones, including free triiodothyronine (FT3), free thyroid hormone (FT4) and thyrotropin (TSH), were measured in each group. The correlation between them was analyzed by Pearson correlation analysis and multivariate stepwise regression analysis. Results (1) with the increase of hypertension, the level of TSH increased [0.42 (0.220.88) vs 0.80 (0.331.01) vs 1.45 (0.970.11) vs 2.75 (2.104.20) m IU/L] FT3 decreased [(5.31 卤0.54) vs (4.79 卤0.66) vs (4.47 卤0.52) vs (3.51 卤0.30) pmol/L] (P0.05). There was no statistical difference [(16.26 卤2.71) vs (16.04 卤2.75) vs (15.39 卤3.41) vs (16.30 卤2.70) pmol/L] (P0.05); (2) Pearson correlation analysis showed that FT _ 3 was negatively correlated with hypertension grade and age (r = -0.408 and -0.194) vs (0.000 and 0.042). There was a positive correlation between HDL-C and HDL-C (r = -0.227 and 0.189), but no correlation with the grade of hypertension (r = 0.017 / P ~ (0.463). There was a positive correlation between HDL-C and LDL-C and SUA (r = 0.357n 0.196 0.2770.1230.214 and 0.342P ~ (0.005) 0.041a 0.0460.020 and 0.001), and a negative correlation was found with Hb A1c (r -0.222P 0.034); (3), and the correlation between Hb A1c and Hb A1c was negative (r = 0.222P 0.034); (3), and was negatively correlated with Hb A1c (r-0.222P 0.034); (3), and was negatively correlated with Hb A1c (r-0.222P 0.034); (3), and was negatively correlated with Hb A1c (r-0.222P 0.034); (3). The influencing factors of hypertension grade and age were FT3 (all P0. 00), hypertension grade and SUA were the influencing factors of TSH (all P0. 00) FT4 was not found. Conclusion with the increase of blood pressure, the level of FT3 decreases and the level of FT4 does not change, and the grade of hypertension is the influencing factor of FT3 and TSH.
【作者单位】：河南省新乡市中心医院内分泌科;
【分类号】：R544.1;R587.1

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