老年2型糖尿病病人甲状腺激素的变化及相关因素分析

发布时间：2019-05-18 15:43

【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(P0.05)。(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(P0.05)。(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。
[Abstract]:Objective to investigate the changes of thyroid hormone in elderly patients with type 2 diabetes mellitus (T2DM), and to analyze its clinical significance and related risk factors. Methods in this case-control study, 140 elderly patients with type 2 diabetes mellitus (type 2 diabetes mellitus,T2DM) were randomly selected as the case group by digital table method, and 147 healthy elderly patients without diabetes mellitus were selected as the control group at the same time. Intravenous blood samples were collected for thyrotropin (thyroid-stimulating hormone,TSH), triiodothyronine (triiodothyronine,T3), tetraiodothyronine (thyroxine,T4), thyroid peroxide antibody (anti-thyroid peroxidase antibody,TPOAb), Thyroglobulin antibody (anti-thyroglobulin antibody,TGAb), thyrotropin receptor antibody (thyroid-stimulating hormone receptor antibodies,TRAb), thyroid color Doppler ultrasound (CDU) were detected. Fasting blood glucose (fasting plasma glucose,FPG), glycosylated hemoglobin (glycosylated hemoglobin A1c, HbA1c) were also tested in the case group. FPG and HbA1c were divided into several groups according to age, course of disease, FPG and HbA1c. The changes of thyroid hormones between the case group and the control group and the case group were compared, and the related risk factors were analyzed. Results (1) compared with the control group, T3 in the case group was significantly lower than that in the control group (P 0.05). (2). With the increase of age, the course of disease and the increase of FPG and HbA1c in the elderly diabetic patients, T3 in the case group showed a downward trend. The difference was statistically significant (P 0.05). (3). Regression analysis showed that T3 was negatively correlated with age, course of disease and FPG,HbA1c in the case group. Course of disease, HbA1c is an independent risk factor affecting T3. Conclusion T3 in elderly diabetic patients has been decreased to varying degrees, and the determination of thyroid hormone concentration in diabetic patients can reflect the disorder of glucose metabolism.
【作者单位】：北京老年医院内分泌科;首都医科大学附属北京同仁医院内分泌科;
【分类号】：R587.1

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