2型糖尿病患者甲状腺功能与纤维蛋白原的关系的研究

　　刘丽君贺佩祥 任志强 钟雅琴 彭韦霞 李菊香 徐雪辉 彭可 陈锋

　　[摘要] 目的 探讨T2DM患者甲状腺功能与纤维蛋白原(FIB)的相关性。 方法 选取T2DM患者502例，测定FIB、(游离三碘甲状腺原氨酸)FT3、(游离甲状腺素)FT4、(促甲状腺激素)TSH和临床生化指标，采用方差分析、Spearman相关分析及多元逐步回归分析甲状腺功能与FIB的相关性。分析甲状腺功能与FIB的相关性。结果 (1)FT3与FIB呈负相关,(r=-0.331,P<0.01)。(2)甲减组FIB高于甲亢组[(3.765±1.089)vs(3.346±0.879)pmol/L，P<0.01],与正常组(3.232±0.985)pmol/L比较差异无统计学意义;按FIB由低到高四分位间距分组，FT3依次为(4.54±0.96)，(4.47±0.81)，(3.94±1.13)及(3.67±0.95)pmol/L，P0～组与P25～组均高于P75～组(P<0.01)。(3)年龄、[脂蛋白LP(a)]、C-RP、HbA1c是FIB的独立影响因子(β=0.382，0.272，0.552，0.221;P< 0.05);FT3呈C-RP依赖性,且与FIB呈负相关(β=-0.289，P<0.01)。结论 T2DM患者年龄、LP(a)、C-RP、HbA1c、FT3均与FIB相关，甲状腺激素可能通过炎症机制影响FIB。

　　【关键词】糖尿病, 2型;甲状腺 ;纤维蛋白原

　　【ABSTRCT】Objectives To study the correlation between thyroid function and fibrinogen ( FIB ) in patients with T2DM. Methods Methods 502 patients with T2DM were enrolled who treated in Endocrinology department of yiyang central hospital in 2010.5~2012.8. Clinical biochemical indicators (liverLiver function，renal function, CR-P, FC-P, HbA1c), HBA1C,FIB and thyroid hormones(FT3、FT4、TSH) were detected in all patients. Spearman correlation analysis,partial correlation analysis of variance and the multivariablemultivariate linear stepwise regression analysis were adopted to analyze the correlation between thyroid function and FIB.. Results FIB was negatively correlated with FT3 (r = -0.331, P < 0.01). I. II. FIB wasis higher in the hypothyroidism group than in hyperthyroidism group[(3.765±1.089) vs (3.346±0.879)pmol/L, P<0.01], and the difference in FIB between hypothyroidism group(3.765±1.089) and the normal group (3.232±0.985)pmol/L was not statistically significant. According to interquartile grouping of FIB from low to high, FT3 were (4.54±0.96), (4.47±0.81),(3.94±1.13) and (3.67±0.95)pmol/L. FT3 was[(3.765±1.089vs3.232±0.985)pmol/l,P<0.01]; FT3 is higher in the P0 and P25 groups than in P75 group (P<0.01). Age， LP (a) ，C-RP，CRP and HbA1c were HBA1C are the independent relative factors for FIBfacter (Beta =0.382，0.272, 0.552,0.221,P< 0.05). FT3 was incorreced with FIB dependent on CRP and negatively correlated with FIB of CRP(Beta=-0.289,P< < 0.01). Conclusion Age，LP(a),C-RP,HbA1cs ：Age，LP(a),C-RP,HBA1C and FT3 of patients with T2DM are correlatedcorrected with FIB. Thyroid hormone may influence on FIB through the mechanism of inflammation. .the highest quarter[(4.54±0.96, 4.47±0.81vs3.67±0.95)pmol/l,P<0.01].FT3 was correced with FIB dependent on CRP and negatively correlated with FIB of CRP(Beta=-0.289,P< < 0.01).

　　【Key words】 Diabetes mullitus,mellitus, type 2 ;Thyroid; Fibrinogen