1型糖尿病患儿的甲状腺激素水平与糖脂代谢：相关性分析
The thyroid hormone levels and glucose and lipid metabolism in children with type 1 diabetes: a correlation analysis.
作者信息
Yuan Chuanjie, Sun Xiaomei, Liu Yin, Wu Jin
机构信息
Department of Pediatric Endocrinology and Metabolism, West China Second Hospital of Sichuan University, Chengdu, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.
出版信息
Transl Pediatr. 2021 Feb;10(2):276-282. doi: 10.21037/tp-20-204.
BACKGROUND
Type 1 diabetes mellitus (T1DM) is common in clinical setting, the relationship between thyroid hormone levels and glucose and lipid metabolism in patients with T1DM remains unclear. We attempted to analyze the correlation of thyroid hormone levels and blood glucose and lipid metabolism in children with normal thyroid function.
METHODS
Children with T1DM were selected, and 85 healthy children who underwent physical examinations in our hospital as control group. The characteristics and laboratory testing results were compared, the correlation of thyroid hormone levels with blood glucose and blood lipids was analyzed by Pearson correlation analysis.
RESULTS
A total of 167 participants were included. the low-density lipoprotein-cholesterol (LDL-C), triglyceride (TG), fasting blood glucose (FBG), and glycated hemoglobin (HbAlc) in T1DM patients were higher than those in healthy controls, while the high-density lipoprotein-cholesterol (HDL-C), thyroid stimulating hormone (TSH) and free triiodothyronine (FT3) in T1DM patients were lower than that of healthy children (all P<0.05). TSH was positively correlated with LDL-C (r=0.169, P=0.032), TC (r=0.182, P=0.017) and TG (r=0.197, P=0.008), negatively correlated with FBG (r=-0.196, P=0.023) and HbAlc (r=-0.328, P=0.002). FT3 was negatively correlated with TG (r=-0.182, P=0.011), FBG (r=-0.184, P=0.009) and HbAlc (r=-0.223, P=0.005). TG in the high TSH group and the middle TSH group is higher than that of low TSH group. However, FBG and HbAlc were lower than those in the low TSH group (all P<0.05). Compared with the low FT3 group, the TG, FBG and HbAlc decreased in the high and middle FT3 group (all P<0.05).
CONCLUSIONS
The serum TSH are closely associated with FT3 and glycolipid metabolism in children with T1DM, which may be the useful indicators to assess the severity of T1DM in clinical settings to provide insights into the management of T1DM.
背景
1型糖尿病（T1DM）在临床中较为常见，T1DM患者甲状腺激素水平与糖脂代谢之间的关系尚不清楚。我们试图分析甲状腺功能正常的儿童甲状腺激素水平与血糖及脂代谢的相关性。
方法
选取T1DM患儿，并选取85例在我院进行体检的健康儿童作为对照组。比较两组的特征及实验室检查结果，采用Pearson相关分析甲状腺激素水平与血糖及血脂的相关性。
结果
共纳入167名参与者。T1DM患者的低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TG）、空腹血糖（FBG）和糖化血红蛋白（HbAlc）高于健康对照组，而T1DM患者的高密度脂蛋白胆固醇（HDL-C）、促甲状腺激素（TSH）和游离三碘甲状腺原氨酸（FT3）低于健康儿童（均P<0.05）。TSH与LDL-C（r=0.169，P=0.032）、总胆固醇（TC）（r=0.182，P=0.017）和TG（r=0.197，P=0.008）呈正相关，与FBG（r=-0.196，P=0.023）和HbAlc（r=-0.328，P=0.002）呈负相关。FT3与TG（r=-0.182，P=0.011）、FBG（r=-0.184，P=0.009）和HbAlc（r=-0.223，P=0.005）呈负相关。高TSH组和中TSH组的TG高于低TSH组。然而，FBG和HbAlc低于低TSH组（均P<0.05）。与低FT3组相比，高FT3组和中FT3组的TG、FBG和HbAlc降低（均P<0.05）。
结论
T1DM患儿血清TSH与FT3及糖脂代谢密切相关，这可能是临床评估T1DM严重程度的有用指标，为T1DM的管理提供思路。
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