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2型糖尿病患者的甲状腺功能障碍

Thyroid Dysfunction in Type 2 Diabetes Mellitus Patients.

作者信息

Subekti Imam, Pramono Laurentius Aswin, Dewiasty Esthika, Harbuwono Dante Saksono

机构信息

Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

出版信息

Acta Med Indones. 2017 Oct;49(4):314-323.

Abstract

BACKGROUND

thyroid dysfunction is more likely to occur in diabetes mellitus patients than general population. Until now, no study has been done to find prevalence of hypothyroidism and hyperthyroidism in Indonesian diabetics. This study aimed to find the proportion and characteristics of thyroid dysfunction in Indonesian type 2 diabetes mellitus patients.

METHODS

a cross-sectional study was conducted in Endocrine and Diabetes Polyclinic, Department of Internal Medicine, Cipto Mangunkusumo Hospital from July to September 2015. This study include type 2 diabetes mellitus patients, age ≥ 18 year-old, willing to undergo thyroid laboratory testing. In this study, hypothyroidism defined as TSH more than 4.0 mIU/L, while hyperthyroidism is defined as TSH less than 0.4 mIU/L with eCLIA.

RESULTS

from 364 subjects who were recruited from Endocrine and Diabetes Polyclinic, Cipto Mangunkusumo Hospital, 303 subjects underwent this study until analysis. Two hundred and three (273) subjects (90.1%) were euthyroid, 7 subjects (2.31%) were hyperthyroid, and 23 subjects (7.59%) were hypothyroid. Majority of the patients had subclinical hypothyroidism (56.5% based on Zulewski and Billewicz Score and 65.2% based on fT4 laboratory result), while 42.9% and 71.4% subjects had clinical hyperthyroidism based on clinical appearance and fT4 laboratory result respectively.

CONCLUSION

proportion of hypothyroidism was 7.59% and hyperthyroidism was 2.31%, while the proportion of total thyroid dysfunction was 9.9% among diabetics. It is suggested that screening for thyroid dyscfunction can be done in high risk condition as a part of comprehensive management in type 2 diabetes mellitus patients.

摘要

背景

糖尿病患者比普通人群更易发生甲状腺功能障碍。迄今为止,尚未有研究探寻印度尼西亚糖尿病患者中甲状腺功能减退和甲状腺功能亢进的患病率。本研究旨在查明印度尼西亚2型糖尿病患者甲状腺功能障碍的比例及特征。

方法

2015年7月至9月在西爪哇省勿加泗市西托·曼古库苏莫医院内科内分泌与糖尿病综合门诊进行了一项横断面研究。本研究纳入年龄≥18岁、愿意接受甲状腺实验室检测的2型糖尿病患者。在本研究中,甲状腺功能减退定义为促甲状腺激素(TSH)高于4.0 mIU/L,而甲状腺功能亢进定义为采用电化学发光免疫分析(eCLIA)法检测TSH低于0.4 mIU/L。

结果

从西托·曼古库苏莫医院内分泌与糖尿病综合门诊招募的364名受试者中,有303名受试者接受了本研究直至分析阶段。273名受试者(90.1%)甲状腺功能正常,7名受试者(2.31%)甲状腺功能亢进,23名受试者(7.59%)甲状腺功能减退。大多数患者患有亚临床甲状腺功能减退(根据祖莱夫斯基和比莱维茨评分法为56.5%,根据游离甲状腺素(fT4)实验室结果为65.2%),而分别根据临床表现和fT4实验室结果,42.9%和71.4%的受试者患有临床甲状腺功能亢进。

结论

糖尿病患者中甲状腺功能减退的比例为7.59%,甲状腺功能亢进的比例为2.31%,而甲状腺功能障碍的总比例为9.9%。建议在高危情况下对甲状腺功能障碍进行筛查,作为2型糖尿病患者综合管理的一部分。

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