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目的探讨2型糖尿病患者和甲状腺疾病患者血浆脂联素水平变化情况。方法选取本院2013年1月~2015年12月收治的70例2型糖尿病和70例甲状腺疾病患者作为本次研究对象,按照中国肥胖成年人标准,并根据患者体质量指数(BMI)将2型糖尿病患者分组为糖尿病肥胖组(BMI≥25kg/m~2)与糖尿病非肥胖组(BMI<25kg/m~2),分别为40例、30例;70例甲状腺疾病患者分为甲亢组(40例)和甲减组(30例),另选择同期来院健康体检的健康人群40例作为本次研究对照组,且BMI<25kg/m~2)。抽取患者空腹下静脉血液,并采用葡萄糖氧化酶法检测器血糖水平,采用电化学发光法检测其胰岛素水平;采用自动化学发光分析仪检测其FT3、FT4、TSH;采用酶联免疫吸附法检测其脂联素水平及血浆游离脂肪酸。结果甲亢患者脂联素水平为(11.9±6.7)ug/L明显高于其他组,差异具有统计学意义(P<0.05);糖尿病肥胖组患者脂联素水平为(4.7±1.9)ug/L明显低于糖尿病非肥胖患者组(7.1±3.7)ug/L、对照组(6.8±3.3)ug/L,差异具有统计学意义(P<0.05);然糖尿病非肥胖组与对照组比较,差异无统计学意义(P>0.05)。脂联素水平与总胆固醇(r=-0.30)、甘油三酯(r=-0.30)、BMI(r=-0.37)及低密度脂蛋白胆固醇(r=-0.24)、空腹胰岛素(r=-0.27)、空腹血糖(r=-0.27)、胰岛素抵抗(r=-0.23)呈负相关。在甲亢及甲减患者中,脂联素水平与FT4呈正相关(r=0.49,P<0.05);然与总胆固醇(r=-0.40)、低密度脂蛋白胆固醇(r=-0.36)呈负相关。于糖尿病及对照组中,脂联素水平与BMI(r=-0.37)、总胆固醇(r=-0.37)呈负相关。BMI是2型糖尿病和甲状腺疾病患者脂联素水平影响最为显著的因素;FT4为甲状腺疾病患者脂联素水平影响最为显著的因素。结论加强对2型糖尿病和甲状腺疾病患者肥胖程度的控制,同时做好甲状腺疾病患者FT4水平的检测,有利于患者临床疾病治疗和脂联素水平的控制,更好地改善其预后。
Objective To investigate the changes of plasma adiponectin level in patients with type 2 diabetes mellitus and thyroid diseases. Methods Seventy patients with type 2 diabetes mellitus and 70 thyroid diseases admitted to our hospital from January 2013 to December 2015 were enrolled in this study. According to the standard of Chinese obese adults and according to the body mass index (BMI), 2 Diabetic patients were divided into diabetic obesity group (BMI≥25kg / m ~ 2) and diabetes non-obese group (BMI <25kg / m2), 40 cases and 30 cases, respectively; 70 cases of thyroid disease were divided into hyperthyroidism group 40 cases) and hypothyroidism group (30 cases). Another 40 healthy subjects selected as healthy subjects during the same period as control group and BMI <25kg / m ~ 2. Fasting blood samples were collected from patients undergoing fasting blood glucose and blood glucose levels were measured by glucose oxidase method. The levels of insulin were detected by chemiluminescence assay. FT3, FT4 and TSH were detected by automated chemiluminescence analyzer. The enzyme-linked immunosorbent assay Adiponectin levels and plasma free fatty acids. Results The level of adiponectin in patients with hyperthyroidism was (11.9 ± 6.7) ug / L, which was significantly higher than that in other groups (P <0.05). The level of adiponectin in obese diabetic patients was (4.7 ± 1.9) ug / L (7.1 ± 3.7) ug / L in the non-obese diabetic group and 6.8 ± 3.3 ug / L in the control group (P <0.05). However, compared with the control group, the difference was statistically significant No statistical significance (P> 0.05). Adiponectin levels were positively correlated with total cholesterol (r = -0.30), triglyceride (r = -0.30), BMI (r = -0.37) and low density lipoprotein cholesterol (r = -0.24) 0.27), fasting blood glucose (r = -0.27) and insulin resistance (r = -0.23). In patients with hyperthyroidism and hypothyroidism, adiponectin levels were positively correlated with FT4 (r = 0.49, P <0.05), but negatively correlated with total cholesterol (r = -0.40) and low density lipoprotein cholesterol Related. In diabetes and controls, adiponectin levels were negatively correlated with BMI (r = -0.37) and total cholesterol (r = -0.37). BMI is the most significant factor affecting the level of adiponectin in patients with type 2 diabetes and thyroid disease; FT4 is the most significant factor affecting the level of adiponectin in patients with thyroid disease. Conclusions To strengthen the control of obesity in patients with type 2 diabetes mellitus and thyroid diseases and to detect the level of FT4 in patients with thyroid diseases, it is beneficial to the treatment of patients with clinical diseases and to the control of adiponectin levels to better improve their prognosis.