糖尿病伴发症研究

　　【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，分析T2DM患者合并甲减的相关因素。 结果 甲减组年龄[(61.03±10.93) vs (54.89±11.17)岁]、女性患者比例[67(67.0%) vs 430(41.7%)]、T2DM病程[10.0(4.0，16.0) vs 6.0(2.0，11.0)年]、SBP[(141.55±20.24) vs (136.52±19.46)mmHg]、促甲状腺激素(TSH)[(10.94±15.21) vs (1.58±0.82)μU/ml]、使用胰岛素治疗者比例[61(61.0%) vs 456(44.2%)]和甲状腺过氧化物酶抗体(TPO-Ab)阳性率[45(45.0%) vs 111(10.8%)]较T2DM组高(P<0.05或P<0.01)，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)%]、游离三碘甲腺原氨酸(FT3)[3.94(3.39，4.32) vs 4.43(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%) vs 363(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、胰岛素治疗和甲状腺过氧化物酶抗体(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。

　　【关键词】糖尿病，2型;甲状腺功能减退;相关因素

　　【Abstract】 Objective To explore the correlates of hypothyroidism in T2DM patients. Methods A case-control study was conducted in patients with T2DM. All the participants were admitted in Metabolic Diseases Hospital, Tianjin Medical University for the first time during August 30, 2011 to May 30, 2012. 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 T2DM 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 [(10.94±15.21) vs (1.58±0.82)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 (P<0.05 or P<0.01), 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 T2DM 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 T2DM patients. Conclusion Age, smoking and TPO-Ab were related to hypothyroidism in T2DM patients. Insulin therapy may also be relate to hypothyroidism in T2DM patients.

　　【Key words】Diabetes mellitus，type 2;Hypothyroidism;Case-control study; Correlates