[摘要] 目的 探讨T2DM患者血清促甲状腺激素(TSH)水平与胰岛β细胞功能的关系。方法 甲状腺功能正常的T2DM患者524例,根据其TSH四分位分为4组，稳态模型评估法比较各组间胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)和其他生化指标。 结果 Q4组HOMA-β明显高于其他3组，而HbA1c、糖化血清蛋白(GA)明显低于其他3组，但4组间HOMA-IR差异无统计学意义。相关分析显示,HOMA-β与BMI、DC-P及TSH等呈正相关，与HbA1c及GA呈负相关.逐步回归分析则表明,BMI、TSH和HbA1c是HOMA-β的独立影响因素。女性T2DM患者TSH明显高于男性，且绝经后女性TSH水平明显高于绝经前。逐步回归分析表明，性别是TSH的独立影响因素。结论 血清TSH与HOMA-β相关，正常范围内高水平的血清TSH提示患者有较好的胰岛β细胞功能。且TSH存在性别差异。

　　[关键词] 糖尿病， 2型;促甲状腺激素;胰岛β细胞功能;性别

　　[Abstract] Objective To investigate the characteristics of serum thyroid-stimulating hormone (TSH) level in type 2 diabetes mellitus (T2DM) patients and the relationship between TSH level and the function of islet β-cell. Methods A total of 524 patients were enrolled in this cross-sectional study, and their TSH level were divided into quartile groups. The relationship of clinical characteristics and biochemical indexes including HbA1c，HOMA-IR, HOMA-β with TSH were analyzed. Results The levels of HOMA-β were significantly higher in the fourth quartile than in other three TSH quartiles，while HbA1c and GA in the fourth quartile were significantly lower than other three quartiles (all p < 0.01). However, there was no statistical difference in HOMA-IR among four groups. Spearman correlation analysis showed that HOMA-β was positively correlated with BMI, ΔC-p and TSH, but negatively correlated with HbA1c, GA. Multiple stepwise regression analysis further revealed that BMI, TSH and HbA1c were independently associated factors of HOMA-β.TSH levels were significantly higher in females than in males, and serum TSH levels were significantly higher in postmenopausal women than in premenopausal women. Multiple stepwise regression analysis revealed that gender was an independently associated factor of TSH. Conclusions Serum TSH level is associated with islet β-cell function, and higher TSH level but in normal range predicts better islet β-cell function. And there is a difference in serum TSH level between two genders.

　　[Key words] Diabetes mellitus, type 2; Thyroid-stimulating hormone; Pancreatic beta cell function; Gender