希腊 1 型和 2 型糖尿病患者甲状腺功能障碍作为被忽视的合并症。
Thyroid Dysfunction among Greek Patients with Type 1 and Type 2 Diabetes Mellitus as a Disregarded Comorbidity.
机构信息
Diabetes Center, 2nd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Hippokration General Hospital of Athens, Athens, Greece.
出版信息
J Diabetes Res. 2017;2017:6505814. doi: 10.1155/2017/6505814. Epub 2017 Oct 30.
INTRODUCTION
The aim of this study was to determine the prevalence of thyroid dysfunction in Greek patients with type 1 (T1DM) and type 2 (T2DM) diabetes mellitus as well as its possible relations to glycaemic control and to diabetic complications.
METHODS
A total of 1015 patients, consecutively followed in the Outpatient Diabetes Center, were studied. Anthropometric and biochemical measurements, occurrence of diabetes complications, and classical comorbidities were assessed. Average HbA1c of the previous year was calculated. Wellbeing was determined, using a 10-point optimal scale. All the above parameters were compared between subjects with or without thyroid disease.
RESULTS
All patients were euthyroid at the time of the study, either on thyroid medications or not. Hypothyroidism occurrence did not differ between T2DM and T1DM patients (37.1% versus 43.5%, > 0.05). Nodular goiter was observed more frequently in T2DM patients (34.1% versus 18.8%, < 0.05). T2DM patients with hypothyroidism compared to those without hypothyroidism had higher HbA1c (7.27% versus 6.98%, < 0.01), TChol (184.97 mg/dl versus 168.17 mg/dl, < 0.001), and higher HDL-Chol (51.28 mg/dl versus 46.77 mg/dl, < 0.01). T2DM patients without hypothyroidism had a better wellness feeling (7.5 versus 5.3 points, < 0.01).
CONCLUSIONS
Screening for thyroid disease among T2DM patients should be routinely considered, as it is found to be an additional commorbidity. If it remains undiagnosed, it could aggravate the clinical course of the disease.
简介
本研究旨在确定希腊 1 型（T1DM）和 2 型（T2DM）糖尿病患者甲状腺功能障碍的患病率，以及其与血糖控制和糖尿病并发症的可能关系。
方法
对连续在门诊糖尿病中心就诊的 1015 例患者进行研究。评估了人体测量和生化测量、糖尿病并发症的发生情况以及经典的合并症。计算了前一年的平均 HbA1c。使用 10 分最佳量表确定了幸福感。比较了有或无甲状腺疾病患者之间的所有上述参数。
结果
所有患者在研究时均处于甲状腺功能正常状态，无论是在服用甲状腺药物还是未服用药物。T2DM 和 T1DM 患者的甲状腺功能减退发生率无差异（37.1%与 43.5%， > 0.05）。结节性甲状腺肿在 T2DM 患者中更为常见（34.1%与 18.8%， < 0.05）。与无甲状腺功能减退的患者相比，有甲状腺功能减退的 T2DM 患者的 HbA1c 更高（7.27%与 6.98%， < 0.01），总胆固醇（TChol）更高（184.97mg/dl 与 168.17mg/dl， < 0.001），高密度脂蛋白胆固醇（HDL-Chol）更高（51.28mg/dl 与 46.77mg/dl， < 0.01）。无甲状腺功能减退的 T2DM 患者的健康感更好（7.5 与 5.3 分， < 0.01）。
结论
应常规考虑对 T2DM 患者进行甲状腺疾病筛查，因为它被认为是一种额外的合并症。如果未被诊断出，它可能会加重疾病的临床病程。
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