亚临床甲状腺功能减退对2型糖尿病患者血尿酸水平的影响

摘要

目的 探讨亚临床甲状腺功能减退(SCH)对2型糖尿病(T2DM)患者血尿酸水平以及相关指标的影响.方法 回顾性分析872例2型糖尿病患者病例资料,根据血促甲状腺激素(TSH)水平分为SCH组(102例)、甲状腺功能正常组(770例).收集两组患者临床资料、甲状腺功能、血尿酸及其他生化指标.比较两组血尿酸的差异并分析血尿酸与其他指标的关系.结果 (1)与甲状腺功能正常组相比,SCH组病程、年龄、体质量指数(BMI)、尿酸(SUA)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb) 水平均升高,而空腹血糖(FPG)、糖化血红蛋白(HbA1c)、游离甲状腺素 (FT4)水平降低,差异有统计学意义(P<0.05).而游离三碘甲状腺原氨酸(FT3)、高密度脂蛋白胆固醇(HDL-C)差异无统计学意义(P>0.05).(2)Pearson相关性分析显示,TSH与血清尿酸(SUA)、病程、BMI、TG、TC、LDL-C、TPOAb、TGAb呈显著正相关,而与FPG、HbA1c和FT4 呈显著负相关.(3)在调整年龄、性别、病程、BMI、TG、TC、LDL-C、FBG、FT4和TSH 等指标后,多元逐步线性回归提示,SUA与年龄、TG、FT4、TSH密切相关.结论 SCH是2型糖尿病患者高尿酸血症的独立危险因素.%Objective To analyze the effects and the related factors of subclinical hypothyroidism on serum uric acid(SUA) in type 2 diabetes patients(T2DM).Methods 872 patients with T2DM were enrolled from our hospital and divided into subclinical hypothyroidism group(n=102) and euthyroidism group (n=770)according to serum TSH level.Clinical data,thyroid function,serum uric acid and other biochemical indexes were collected for all subjects,then the difference of serum uric acid level between two groups was evaluated.Results (1) Compared with the euthyroidism group,the diabetic course,age,BMI,SUA,TG,TC,LDL-C,TPOAb,TGAb level were significantly higher,and FPG,HbA1c,FT4 levels were significantly lower(P<0.05)in subclinical hypothyroidism group.There were no significant differences in serum FT3 and HDL-C levels between two groups.(2) Pearson correlation analysis showed that TSH level was positively correlated with SUA,diabetic course,BMI,TG,TC,LDL-C,TPOAb,TGAb and negatively correlated with FPG,HbA1c and FT4.(3)After adjusting age,gender,diabetic course,BMI,TG,TC,LDL-C,FBG,FT4 and TSH,multivariate regression analysis showed that SUA was associated with the age,TG,FT4 and TSH.Conclusion Subclinical hypothyroidism is one of the independent risk factors of hyperuricemia in type 2 diabetics.