Huang Xiuting, Zhang Xiuying, Zhou Xianghai, Han Xueyao, Fu Zuodi, Li Yufeng, Ji Linong
Department of Endocrinology and Metabolism, Peking University People's Hospital, Peking University Diabetes Center, Beijing 100044, People's Republic of China.
Department of Endocrinology and Metabolism, Capital Medical University Pinggu Teaching Hospital, Beijing 101200, People's Republic of China.
Diabetes Metab Syndr Obes. 2020 Nov 16;13:4361-4368. doi: 10.2147/DMSO.S271328. eCollection 2020.
Impaired glucose metabolism and thyroid dysfunction (TD) are the two most common chronic metabolic disorders. This study aimed to investigate the epidemiological characteristics of TD in different status of glucose tolerance in a community-based Chinese population and to understand the association between TD and glucose metabolism.
A community-based population study of metabolic disease was conducted from June 2013 to September 2014 in Beijing, China. Residents aged 26-76 years were selected according to gender and age composition using multi-stage stratified random sampling process. All participants underwent serum thyroid function and thyroid-associated antibody tests. The status of glucose tolerance was determined using 75g-oral glucose tolerance test. Chi-square test was used to compare the differences in prevalence. Multivariate logistic regression analysis was used to determine the impact of insulin resistance (IR) on thyroid function.
By analyzing 3986 participants who were included in the survey, the prevalence of type 2 diabetes (T2DM) and pre-diabetes (pre-DM) was 18.59% and 26.79%, respectively. The prevalence of TD was 8.81%, with overt hyperthyroidism accounting for 0.38%; subclinical hyperthyroidism, 1.86%; overt hypothyroidism, 0.70%; and subclinical hypothyroidism, 5.87%. The prevalence of TD increased with gradually deteriorated glucose tolerance (7.63% in those with normal glucose tolerance, 9.27% in pre-DM, and 11.61% in T2DM) in both men and women. Each unit of higher HOMA-IR was associated with 7% higher likelihood of having subclinical hypothyroidism.
The coexisting of TD with T2DM and pre-DM is high in this community-based Chinese population, suggesting a close relationship between TD and glucose metabolism.
葡萄糖代谢受损和甲状腺功能障碍（TD）是两种最常见的慢性代谢性疾病。本研究旨在调查中国社区人群不同糖耐量状态下TD的流行病学特征，并了解TD与葡萄糖代谢之间的关联。
2013年6月至2014年9月在中国北京进行了一项基于社区的代谢性疾病人群研究。采用多阶段分层随机抽样方法，根据性别和年龄构成选取26 - 76岁的居民。所有参与者均接受血清甲状腺功能和甲状腺相关抗体检测。采用75克口服葡萄糖耐量试验确定糖耐量状态。采用卡方检验比较患病率差异。采用多变量逻辑回归分析确定胰岛素抵抗（IR）对甲状腺功能的影响。
通过分析纳入调查的3986名参与者，2型糖尿病（T2DM）和糖尿病前期（pre-DM）的患病率分别为18.59%和26.79%。TD的患病率为8.81%，其中显性甲亢占0.38%；亚临床甲亢占1.86%；显性甲减占0.70%；亚临床甲减占5.87%。男性和女性中，TD的患病率均随着糖耐量逐渐恶化而增加（糖耐量正常者为7.63%，糖尿病前期为9.27%，T2DM为11.61%）。较高的稳态模型评估胰岛素抵抗（HOMA-IR）每升高一个单位，患亚临床甲减的可能性就增加7%。
在这个中国社区人群中，TD与T2DM和糖尿病前期共存的情况很常见，提示TD与葡萄糖代谢之间存在密切关系。
