Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Department of intensive care unit, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.
Endocr Res. 2020 Feb-May;45(2):111-118. doi: 10.1080/07435800.2019.1690504. Epub 2019 Nov 27.
: This study aimed to evaluate the association between thyroid parameters and diabetic retinopathy (DR) in euthyroid patients with type 2 diabetes mellitus (T2DM).: In this cross-sectional study, a total of 911 euthyroid patients with T2DM (539 men and 372 women; mean age, 60.81 ± 12.93 years) were enrolled. Clinical factors were assessed and free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) levels were measured. DR was diagnosed using fundus fluorescein angiography.: Compared with patients without DR (n = 718), patients with DR (n = 193) exhibited lower FT3 (4.40 ± 0.58 vs. 4.50 ± 0.51 pmol/L; = .019) and FT4 (14.86 ± 2.09 vs. 15.91 ± 2.18 pmol/L; < .001) and higher TSH (1.86 [1.22, 2.66] vs. 1.58 [1.14, 2.34] µIU/mL; = .015) levels. After adjustment for potential DR risk factors, patients in the highest tertile of plasma FT4 levels had a 0.332-fold likelihood of developing DR compared with those in the lowest tertile of plasma FT4 levels (P < 0.001). The prevalence of DR showed a significantly decreasing trend across the three tertiles based on FT4 levels (31.35%, 19.08% and 13.16%; P < 0.001). Similar results were obtained for the presence of proliferative DR.: These findings suggest that low-normal FT4 levels are associated with the prevalence of DR in euthyroid patients with T2DM.
这项研究旨在评估甲状腺参数与 2 型糖尿病（T2DM）甲状腺功能正常患者糖尿病视网膜病变（DR）之间的关系。在这项横断面研究中，共纳入了 911 例甲状腺功能正常的 T2DM 患者（男 539 例，女 372 例；平均年龄 60.81±12.93 岁）。评估了临床因素并测量了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。使用眼底荧光血管造影诊断 DR。与无 DR 的患者（n=718）相比，有 DR 的患者（n=193）的 FT3（4.40±0.58 与 4.50±0.51 pmol/L；=0.019）和 FT4（14.86±2.09 与 15.91±2.18 pmol/L；＜0.001）水平较低，TSH（1.86[1.22, 2.66]与 1.58[1.14, 2.34]µIU/mL；=0.015）水平较高。在调整了潜在的 DR 危险因素后，血浆 FT4 水平最高三分位的患者发生 DR 的可能性是最低三分位的患者的 0.332 倍（P＜0.001）。根据 FT4 水平，DR 的患病率在 FT4 水平的三个三分位中呈显著下降趋势（31.35%、19.08%和 13.16%；P＜0.001）。FT4 水平同样与增殖性 DR 的存在呈负相关。这些发现表明，甲状腺功能正常的 T2DM 患者中，低正常的 FT4 水平与 DR 的患病率相关。
