Gu Yeqing, Li Huihui, Bao Xue, Zhang Qing, Liu Li, Meng Ge, Wu Hongmei, Du Huanmin, Shi Hongbin, Xia Yang, Su Qian, Fang Liyun, Yu Fei, Yang Huijun, Yu Bin, Sun Shaomei, Wang Xing, Zhou Ming, Jia Qiyu, Guo Qi, Chang Hong, Wang Guolin, Huang Guowei, Song Kun, Niu Kaijun
Nutritional Epidemiology Institute and School of Public Health, and.
Health Management Centre, Tianjin Medical University General Hospital, 300070 Tianjin, China.
J Clin Endocrinol Metab. 2017 Feb 1;102(2):434-442. doi: 10.1210/jc.2016-2965.
Thyroid hormones (THs) are primarily responsible for the regulation of energy balance and metabolism, suggesting that TH levels may contribute to the development of type 2 diabetes mellitus (T2DM). However, few studies have investigated the relationship between TH and T2DM in a general population. The aim of this study was to evaluate whether serum TH levels within the reference range are related to T2DM.
A cross-sectional study (n = 15,296) was performed in Tianjin, China. Serum free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH) levels were measured by chemiluminescence immunoassay, and T2DM was defined according to the American Diabetes Association criteria. Multiple logistic regression models were used to assess the sex-specific relationships between FT3, FT4, FT3/FT4 ratios, and TSH quintiles and T2DM.
The prevalence of T2DM was 16.2% in males and 7.7% in females. In males, the multivariable-adjusted odds ratios (95% confidence interval) of T2DM for increasing quintiles of FT3, FT4, and FT3/FT4 ratios were 1.00, 0.75(0.63 to 0.89), 0.70(0.58 to 0.84), 0.63(0.52 to 0.76), 0.56(0.46 to 0.68; P for trend < 0.0001); 1.00, 1.05(0.87 to 1.27), 1.16(0.96 to 1.40), 1.09(0.90 to 1.31), 1.29(1.07 to 1.56; P for trend = 0.01); and 1.00, 0.69(0.58 to 0.83), 0.72(0.60 to 0.86), 0.59(0.48 to 0.71), and 0.55(0.46 to 0.66; P for trend < 0.0001), respectively. Similar results also were observed in females. In contrast, a strong negative correlation between TSH and T2DM was observed in males, but not in females.
This study demonstrated that decreased FT3, FT3/FT4 ratios, and increased FT4 levels are independently related to a higher prevalence of T2DM in both males and females, and TSH is inversely related to T2DM in males only.
甲状腺激素（THs）主要负责能量平衡和代谢的调节，这表明甲状腺激素水平可能与2型糖尿病（T2DM）的发生有关。然而，很少有研究在普通人群中调查甲状腺激素与2型糖尿病之间的关系。本研究的目的是评估参考范围内的血清甲状腺激素水平是否与2型糖尿病有关。
在中国天津进行了一项横断面研究（n = 15296）。采用化学发光免疫分析法测定血清游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）和促甲状腺激素（TSH）水平，并根据美国糖尿病协会标准定义2型糖尿病。使用多因素逻辑回归模型评估FT3、FT4、FT3/FT4比值和TSH五分位数与2型糖尿病之间的性别特异性关系。
男性2型糖尿病患病率为16.2%，女性为7.7%。在男性中，FT3、FT4和FT3/FT4比值升高的五分位数对应的2型糖尿病多因素调整优势比（95%置信区间）分别为1.00、0.75（0.63至0.89）、0.70（0.58至0.84）、0.63（0.52至0.76）、0.56（0.46至0.68；趋势P<0.0001）；1.00、1.05（0.87至1.27）、1.16（0.96至1.40）、1.09（0.90至1.31）、1.29（1.07至1.56；趋势P = 0.01）；以及1.00、0.69（0.58至0.83）、0.72（0.60至0.86）、0.59（0.48至0.71）和0.55（0.46至0.66；趋势P<0.0001）。在女性中也观察到了类似结果。相反，在男性中观察到TSH与2型糖尿病之间存在强负相关，而在女性中未观察到。
本研究表明，FT3降低、FT3/FT4比值降低以及FT4水平升高与男性和女性中2型糖尿病的较高患病率独立相关，并且TSH仅在男性中与2型糖尿病呈负相关。
