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目的探讨2型糖尿病(T2DM)患者合并甲状腺功能减退(简称“甲减”)的临床特点。方法选取2014年1月至2016年12月在湖北省黄石市第二医院住院及门诊的1 220例T2DM患者为研究对象,依据《中国甲状腺疾病诊断指南》相关标准,设置甲减组(142例)和甲状腺功能正常组(1 047例)。收集患者的基本资料(年龄、病程等),对患者的甲状腺功能、血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)和糖化血红蛋白(HbA_(1C))水平进行测定。用SPSS 17.0软件进行t检验、χ~2检验和Pearson相关分析。结果 1 220例T2DM患者中甲状腺功能异常者173例,患病率为14.18%。其中,甲状腺功能减退者142例(11.64%),以亚临床甲减(9.34%)为主。与甲状腺功能正常组比较,甲减组年龄大,女性所占比例高,病程长,差异均有统计学意义(P<0.01)。与甲状腺功能正常组比较,甲减组FT3、FT4和FPG水平降低,TSH、TG和LDL-C水平升高,差异均有统计学意义(P<0.01)。两组患者TC、HDL-C和HbA_(1C)水平差异均无统计学意义(P>0.05)。病程、TC、TG、LDL-C与TSH呈正相关(r值分别为0.273、0.139、0.288和0.132,P<0.01,P<0.05),FPG、HbA_(1C)与TSH呈负相关(r值分别为-0.172、-0.253,P<0.01,P<0.05)。而年龄、HDL-C与TSH无相关性(r值分别为0.078、0.029,P>0.05)。结论 T2DM患者合并甲状腺功能减退者会出现血脂代谢紊乱,应进行早期甲状腺疾病筛查,有利于早发现、早治疗甲状腺疾病。
Objective To investigate the clinical features of patients with type 2 diabetes mellitus (T2DM) complicated with hypothyroidism (referred to as “hypothyroidism”). Methods A total of 1 220 T2DM patients hospitalized and outpatient in the Second Hospital of Huangshi City, Hubei Province from January 2014 to December 2016 were selected as study subjects. According to the relevant criteria of “Guidelines for the Diagnosis of Thyroid Diseases in China”, 142 patients with hypothyroidism ) And normal thyroid function group (1 047 cases). Thyroid function, serum total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL) -C), fasting blood glucose (FPG) and glycated hemoglobin (HbA_ (1C)) were measured. SPSS 17.0 software t test, χ ~ 2 test and Pearson correlation analysis. Results Among the 1 220 T2DM patients, 173 cases had abnormal thyroid function, with a prevalence of 14.18%. Among them, 142 cases of hypothyroidism (11.64%), sub-clinical hypothyroidism (9.34%) based. Compared with the normal thyroid function group, the hypothyroidism group was older, the proportion of women was higher, the course of the disease was longer, the difference was statistically significant (P <0.01). Compared with the normal thyroid function group, the level of FT3, FT4 and FPG decreased and the levels of TSH, TG and LDL-C increased in hypothyroidism group (all P <0.01). There was no significant difference in the levels of TC, HDL-C and HbA_ (1C) between the two groups (P> 0.05). There was a positive correlation between duration of disease, TC, TG, LDL-C and TSH (r = 0.273,0.139,0.288 and 0.132, P <0.01, P <0.05) -0.172, -0.253, P <0.01, P <0.05). The age, HDL-C and TSH no correlation (r values were 0.078,0.029, P> 0.05). Conclusion T2DM patients with hypothyroidism will appear dyslipidemia, screening for early thyroid disease should be conducive to early detection and early treatment of thyroid disease.