Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Diabetes Care. 2010 May;33(5):1018-20. doi: 10.2337/dc09-1784. Epub 2010 Feb 11.
To determine the relationship between subclinical hypothyroidism (SCH) and the prevalence of diabetic retinopathy in type 2 diabetic patients.
A total of 1,170 type 2 diabetic patients were screened for thyroid function. There were 127 type 2 diabetic patients with SCH and 200 randomly selected euthyroid type 2 diabetic patients selected. Those with more severe than moderate nonproliferative diabetic retinopathy were classified as having sight-threatening diabetic retinopathy (STDR).
The trend for severe retinopathy was significantly higher in the SCH group than in the euthyroid group (chi(2) = 20.43, P = 0.000). SCH was associated with greater prevalence of diabetic retinopathy, especially STDR [odds ratio (95% CI): 4.15 (2.17-7.96), P = 0.000] after an adjustment for age, sex, duration of diabetes, A1C, BMI, hypertension, and LDL cholesterol. Even euthyroid patients with thyroid-stimulating hormone levels between 2.0 and <4.0 microIU/ml had a higher rate of STDR then those between 0.4 and <2.0 microIU/ml (P = 0.008).
Type 2 diabetic patients with SCH are associated with an increased risk of STDR.
探讨亚临床甲状腺功能减退症（SCH）与 2 型糖尿病患者糖尿病视网膜病变（DR）患病率之间的关系。
共筛选出 1170 例 2 型糖尿病患者进行甲状腺功能检查。将 127 例 2 型糖尿病 SCH 患者和 200 例随机选择的甲状腺功能正常的 2 型糖尿病患者作为研究对象。将病情较重的非增生性糖尿病视网膜病变患者归入致盲性糖尿病视网膜病变（STDR）。
SCH 组严重视网膜病变的趋势明显高于甲状腺功能正常组（chi(2) = 20.43，P = 0.000）。校正年龄、性别、糖尿病病程、糖化血红蛋白（A1C）、体重指数（BMI）、高血压和低密度脂蛋白胆固醇（LDL-C）后，SCH 与糖尿病视网膜病变，尤其是 STDR 的患病率显著相关[比值比（95%CI）：4.15（2.17-7.96），P = 0.000]。即使甲状腺刺激激素（TSH）水平在 2.0<4.0 μIU/ml 的甲状腺功能正常患者，其 STDR 发生率也高于 0.4<2.0 μIU/ml 者（P = 0.008）。
2 型糖尿病 SCH 患者并发致盲性糖尿病视网膜病变的风险增加。
