血清胰岛素样生长因子-1与糖尿病合并甲状腺疾病的相关性

摘要

目的 探讨血清胰岛素样生长因子-1(IGF-1)在糖尿病合并甲状腺疾病发病过程中的作用,为糖尿病患者的预防和治疗甲状腺疾病提供理论依据,并作为临床干预效果评价的检测指标.方法 选取住院的2型糖尿病患者190例,依据是否合并甲状腺疾病,分为糖尿病合并甲状腺疾病组[又细分为糖尿病合并甲亢组(A组)、糖尿病合并甲减组(B组)、糖尿病合并甲状腺结节组(C组)]和单纯糖尿病组(对照组),分别比较各组血清IGF-1、甲状腺功能、胰岛素、C肽、血糖、糖化血红蛋白、胰岛素抵抗指数、血脂之间的关系.结果(1)糖尿病合并甲亢组、糖尿病合并甲减组患者血清IGF-1水平均低于糖尿病合并甲状腺结节患者和单纯糖尿病患者,差异有统计学意义(P＜0.05).(2)IGF-1与年龄、糖尿病病程、BMI、三碘甲腺原氨酸(T3)、甲状腺素(T4)、游离T3(FT3)、游离T4(FT4)、TgAb、HDL呈负相关(r值分别为-0.307、-0.317、-0.817、-0.204、-0.274、-0.287、-0.208、-0.626、-0.245,P均＜0.05);IGF-1与FPG、2hPPG、Fins、IR呈正相关(r值分别为0.891、0.174、0.661、0.660,均P＜0.05).(3)血清IGF-1与糖尿病合并甲状腺疾病呈负相关.结论 血清IGF-1与糖尿病合并甲状腺疾病相关,可能在疾病发生及发展过程中起重要作用,为糖尿病患者预防甲状腺疾病提供理论依据,可作为临床干预效果评价的检测指标.%Objective To investigate the role of serum insulin-like growth factor-1 (IGF-1) in the pathogenesis of diabetes mellitus complicated with thyroid disease by analyzing the difference of serum IGF-1 among patients with diabetes mellitus and different thyroid diseases; thus to provide theoretical basis for the prevention and treatment of thyroid diseases in diabetes patients. Methods A total of 190 patients with type 2 diabetes mellitus (T2 DM) in the hospital of North China University of Technology from August 2017 to May 2018 were selected and divide into diabetes mellitus combined with thyroid disease groups and simple diabetes mellitus group according to whether they were combined with thyroid disease or not. The serum IGF-1, thyroid function, insulin, C peptide, blood glucose, glycosylated hemoglobin, insulin resistance index and blood lipid among each groups were compared. Results The serum IGF-1 in patients with diabetes mellitus combined with hyperthyroidism and with diabetes mellitus combined with hypothyroidism group were significantly lower than those in patients with diabetes mellitus with thyroid nodules and simple diabetes mellitus (P＜0.05). IGF-1 was significantly negatively correlated with age, course of diabetes mellitus, BMI, T3, T4, FT3, FT4, TGAb and HDL (R values were-0.307, -0.317, -0.817, -0.204, -0.274, -0.287, -0.208, respectively, P＜0.05), as IGF-1 was significantly positively correlated with FPG, 2 hPPG, Fins and IR (R values were 0.891, 0.174, 0.661 and 0.660, respectively, P＜0.05). According to logistic regression, serum IGF-1 was significantly negatively correlated with diabetes mellitus combined thyroid disease.Conclusion The serum IGF-1 is associated with diabetes mellitus complicated with thyroid diseases, and may play an important role in the occurrence and development of the disease. It also provides a theoretical basis for the prevention of thyroid disease in diabetic patients. And it can be used as an index to evaluate the clinical intervention efficacy.