甲状腺功能正常的2型糖尿病TSH水平与颈动脉内中膜厚度的相关性研究

发布时间：2019-07-10 15:10

【摘要】：目的：通过回顾性资料分析甲状腺功能正常的2型糖尿病患者中不同TSH水平与颈动脉内膜中层厚度的关系。方法：收集2013年12月至2016年1月于广西医科大学第一附属医院内分泌科住院病人,共364例甲状腺功能正常的2型糖尿病患者。(1)根据颈动脉内中膜厚度(IMT)分三组：IMT正常组、IMT单纯增厚组、颈动脉斑块组,比较三组间性别、年龄、病程、吸烟、血压、体重指数(BMI)、空腹血糖(FPG)、餐后2小时血糖(PPG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、同型半胱氨酸(HCY)、总蛋白(TP)、24h尿微量白蛋白之间的差异。(2)根据血清TSH水平的实际测量值运用三分位数分为三组：高TSH组、中TSH组及低TSH组,比较三组间性别、年龄、病程、吸烟、血压、BMI、血糖、]EbA1c、 TG、TC、HDL-C、LDL-C、HCY、TP、24h尿微量白蛋白、IMT的差异,同时比较三组间在0个斑块、1个斑块、≥2个斑块的检出率。结果：1.IMT单纯增厚组PPG、TC、LDL-C显著高于IMT正常组(P0.05)；斑块组年龄、病程、收缩压、HCY显著高于IMT正常组(P0.05),TC、LDL-C水平显著低于IMT正常组(P0.05);颈动脉斑块组的年龄、病程、HCY显著高于IMT单纯增厚组(P0.05),而PPG、TC、LDL-C水平显著低于IMT单纯增厚组(P0.05)。2.高TSH组的TC、TG、LDL-C、IMT水平均显著增高于中TSH组和低TSH组(P0.05)；三组间的斑块检出率差异无统计学意义。3.Person相关性分析发现,IMT与年龄、病程、TSH、HCY、TC、LDL-C呈正相关,与TT3呈负相关(P0.05)。4.偏相关分析显示TSH与IMT在2型糖尿病患者中呈显著正相关,并独立于年龄、病程、TT3、HCY、TC、LDL-C等因素。5.多元线性回归分析显示年龄、TSH是影响IMT的独立危险因素。结论：1.在甲状腺功能正常的2型糖尿病患者中,随着TSH水平的升高,TC、 TG、LDL-C、IMT呈递增趋势。2.在甲状腺功能正常的2型糖尿病患者中,年龄、TSH是影响IMT的独立危险因素。
[Abstract]:Objective: to analyze the relationship between different TSH levels and carotid intima-media thickness in patients with type 2 diabetes mellitus with normal thyroid function. Methods: a total of 364patients with type 2 diabetes mellitus with normal thyroid function were collected from December 2013 to January 2016 in the Department of Endocrinology, the first affiliated Hospital of Guangxi Medical University. (1) according to the intima-media thickness of carotid artery, (IMT) was divided into three groups: normal IMT group, IMT thickening group and carotid plaque group. Sex, age, course of disease, smoking, blood pressure and body mass index (BMI), fasting blood glucose (FPG), were compared among the three groups. The differences of postmeal blood glucose (PPG), glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and homocysteine (HCY), total protein (TP), 24 h urinary microalbumin. (2) according to the actual measured value of serum TSH level, they were divided into three groups: high TSH group, In middle TSH group and low TSH group, the differences of sex, age, course of disease, smoking, blood pressure, BMI, blood glucose,] EbA1c, TG,TC,HDL-C,LDL-C,HCY,TP,24h urinary microalbumin and IMT were compared among the three groups, and the detection rates of 0 plaques, 1 plaque and 鈮，

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