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目的分析亚临床甲状腺功能减退症(SCH)对2型糖尿病患者心血管危险因素的影响。方法将2型糖尿病患者414例中合并SCH患者33例作为SCH组,将甲状腺功能正常患者381例作为NO-SCH组。测量2组患者血压、腰围(WC)、身高、体质量,计算体质量指数(BMI),检测空腹血糖(FPG)、餐后2h血糖(2h PG)、血脂、甲状腺功能、视黄醇结合蛋白4(RBP4)并进行比较,分析促甲状腺激素(TSH)与其他指标的相关性。结果 SCH组年龄、TC、TG、HDL-C、RBP4均高于NO-SCH组,DBP低于NO-SCH,差异均有统计学意义(P<0.05或P<0.01);2组病程、WC、BMI、SBP、FPG、2h PG、Hb A1c及LDL-C比较,差异均无统计学意义(P>0.05)。SCH组TSH高于NO-SCH组,FT3、FT4均低于NO-SCH组,差异均有统计学意义(P<0.01)。Spearman相关分析结果显示,TSH与TC、HDL-C及RBP4正相关(r=0.1247,0.0983,0.5077,P均<0.05);与FT4负相关(r=-0.1718,P<0.01);与年龄、病程、LDL-C及TG无明显相关性(P>0.05)。结论 SCH与2型糖尿病患者多个心血管危险因素密切相关,加强SCH的心血管危险因素管理有利于控制糖尿病并发症。
Objective To analyze the effect of subclinical hypothyroidism (SCH) on cardiovascular risk factors in type 2 diabetic patients. METHODS: A total of 414 patients with type 2 diabetes mellitus (SCH) were enrolled as SCH group and 381 patients with normal thyroid function as NO-SCH group. Body mass, body mass index (BMI), fasting blood glucose (FPG), 2h postprandial blood glucose (2h PG), lipids, thyroid function, retinol binding protein 4 (RBP4) and compared to analyze thyrotropin (TSH) and other indicators of relevance. Results The scores of age, TC, TG, HDL-C and RBP4 in SCH group were higher than those in NO-SCH group and DBP was lower than that in NO-SCH group (P <0.05 or P <0.01) , BMI, SBP, FPG, 2h PG, Hb A1c and LDL-C. There was no significant difference (P> 0.05). The TSH in SCH group was higher than that in NO-SCH group, FT3 and FT4 were both lower than those in NO-SCH group, the difference was statistically significant (P <0.01). Spearman correlation analysis showed that TSH was positively correlated with TC, HDL-C and RBP4 (r = 0.1247,0.0983,0.5077, P <0.05), negative correlation with FT4 (r = -0.1718, Duration, LDL-C and TG no significant correlation (P> 0.05). Conclusions SCH is closely related to a number of cardiovascular risk factors in type 2 diabetic patients. Strengthening the management of cardiovascular risk factors in SCH may be helpful in controlling diabetic complications.