2型糖尿病患者合并甲状腺功能减退的相关因素分析

摘要

目的：探讨T2DM患者合并甲状腺功能减退（下称“甲减”）的相关因素。方法选取T2DM合并甲减患者100例作为甲减组，甲状腺功能正常的T2DM患者1031例作为T2DM组，检测两组的一般资料及生化指标。结果甲减组年龄[（61.03±10.93）vs（54.89±11.17）岁]、女性比例[67（67.0％）vs430（41.7％）]、T2DM病程[10.0（4.0，16.0）vs6.0（2.0，11.0）年]、SBP[（141.55±20.24）vs（136.52±19.46）mmHg]、促甲状腺激素（TSH）[5.88（4.94，9.26）vs1.40（0.97，2.02）μU／ml]、胰岛素治疗者比例[61（61.0％）vs456（44.2％）]和甲状腺过氧化物酶抗体（TPO‐Ab）阳性率[45（45.0％）vs111（10.8％）]较T2DM组高，DBP[（79.45±10.15）vs（82.16±11.14）mmHg]、HbA1c[7.9（6.9，9.3）％vs8.4（7.2，10.0）％]、游离三碘甲状腺原氨酸（FT3）[3.94（3.39，4.32）vs4.43（4.01，4.86）pmol／L]、游离甲状腺素（FT4）[（13.97±3.22）vs（17.04±2.13）pmol／L]和吸烟者比例[14（14.0％）vs363（35.2％）]较T2DM组低（P＜0.05或P＜0.01）。Logistic多元回归分析结果显示，年龄、吸烟、胰岛素治疗和TPO‐Ab是T2DM患者合并甲减的影响因素。结论年龄、吸烟和TPO‐Ab是T2DM患者合并甲减的影响因素，胰岛素治疗可能与T2DM患者合并甲减有关。%Objective To explore the correlates of hypothyroidism in T2DM patients. Methods A case‐control study was conducted in patients with T 2DM. They were divided into two groups :T2DM+hypothyroidism patient group and T2DM + euthyroid patient group. Logistic multivariate regression was used to analyze correlates of hypothyroidism in T 2DM patients. Results Age [(61.03 ± 10.93 ) vs (54.89 ± 11.17)years] ,female [67(67.0% ) vs 430(41.7% )] ,T2DM duration [10.0(4.0 ,16.0) vs 6.0 (2.0 ,11.0)years] ,SBP [(141.55 ± 20.24) vs (136.52 ± 19.46)mmHg] ,TSH [5.88(4.94 ,9.26) vs 1.40(0.97 ,2.02 )μU/ml] ,insulin therapy [61 (61.0% ) vs 456 (44.2% )] and positive TPO‐Ab [45 (45.0% ) vs 111(10.8% )] were significantly higher in hypothyroidism group than in T2DM group ,DBP [(79.45 ± 10.15) vs (82.16 ± 11.14)mmHg] ,HbA1c [7.9(6.9 ,9.3)% vs 8.4(7.2 ,10.0)% ] ,FT3 [3.94 (3.39 ,4.32) vs 4.43(4.01 ,4.86)pmol/L] ,FT4 [(13.97 ± 3.22) vs (17.04 ± 2.13)pmol/L] and smoking [14(14.0% ) vs 363(35.2% )] were significantly lower in hypothyroidism group than in T 2DM group (P<0.05 or P< 0.01) .The multivariate logistic regression analysis showed that ,age ,smoking ,insulin therapy and TPO‐Ab were the correlative factors of hypothyroidism in T 2DM patients. Conclusion Age ,smoking and TPO‐Ab were related to hypothyroidism in T2DM patients. Insulin therapy may also be relate to hypothyroidism in T 2DM patients.