·糖尿病临床研究·

　　【摘要】 目的 观察二甲双胍治疗T2DM与亚临床甲状腺功能减退症(甲减)的关系。 方法 选取T2DM患者396例，根据是否使用二甲双胍分为二甲双胍组和对照组，比较两组一般资料和亚临床甲减的发病率，并分析T2DM合并亚临床甲减可能的危险因素。 结果 二甲双胍组BMI[(24.97±3.05) vs (26.71±3.64) kg/m2]、胰岛素抵抗指数(HOMA-IR)[(0.479±0.419) vs (0.605±0.408)]、促甲状腺激素(TSH)[(2.03±1.57) vs (2.48±1.96) uIU/ml]及亚临床甲减的发生率(4.76% vs 10.63%)均低于对照组(P<0.05)。性别是T2DM合并亚临床甲减的危险因素，而使用二甲双胍是保护因素(OR=0.325, P=0.013)。 结论 使用二甲双胍是T2DM合并亚临床甲减的保护因素，其可以降低TSH水平，并降低亚临床甲减发生的可能。

　　【关键词】 糖尿病，2型;亚临床甲状腺功能减退症;二甲双胍

　　【Abstract】 Objective To investigate the relationship between metformin treatment and subclinical hypothyroidism in patients with type 2 diabetes mellitus(T2DM). Methods A total of 396 patients with T2DM were divided into metformin group and control group depending on whether the use of metformin. The general information and the incidence of subclinical hypothyroidism were compared between two groups. The risk factors of T2DM patients with subclinical hypothyroidism were analyzed. Results Compared with the control group, body mass index(BMI) [(24.97±3.05) vs (26.71±3.64) kg/m2], insulin resistance index(HOMA-IR) [(0.479±0.419) vs (0.605±0.408)], thyroid stimulating hormone(TSH) [(2.03±1.57) vs (2.48±1.96) uIU/ml] and incidence of subclinical hypothyroidism(4.76% vs 10.63%) were lower in metformin group(P<0.05).The risk factor of T2DM patients with subclinical hypothyroidism was gender. The use of metformin was a protective factor (OR=0.325, P=0.013). Conclusion The use of metformin was a protective factor in T2DM patients with subclinical hypothyroidism. Metformin treatment may reduce the level of TSH and may decrease the incidence of subclinical hypothyroidism.

　　【Key words】 Diabetes mellitus, type 2; Subclinical hypothyroidism; Metformin