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2型糖尿病患者甲状腺过氧化物酶抗体升高与腹部脂肪分布的关系

Association Between Elevated Thyroid Peroxidase Antibody and Abdominal Fat Distribution in Patients with Type 2 Diabetes Mellitus.

作者信息

Hu Ye, Zheng Jia, Ye Xiao, Song Yingxiang, Wu Xiaohong

机构信息

Department of Health Management Center, Endocrinology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, People's Republic of China.

The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2022 Mar 17;15:863-871. doi: 10.2147/DMSO.S345507. eCollection 2022.

Abstract

OBJECTIVE

Obesity and autoimmune thyroid disease (AITD) are both common disorders in the general population, which are major drivers for adverse medical conditions. While an interaction between thyroid function and visceral obesity is thought to exist, but very few studies have examined the relationship between AITD and visceral obesity, especially in the patients with type 2 diabetes mellitus (T2DM). In the present study, we investigated the association between elevated thyroid peroxidase antibody (TPOAb) titer and visceral fat area in T2DM patients.

METHODS

A total of 390 T2DM patients who met the criteria for admission and joined the National Metabolic Management Center (MMC) in the Zhejiang Provincial People's Hospital from April 2020 to December 2020 were enrolled in this study. The participants were divided into two groups based on visceral obesity. Thyroid function, thyroid associated antibody and other metabolic indicators were measured by blood tests. The visceral fat area (VFA) and the subcutaneous fat area (SFA) were measured by bioelectrical impedance analysis.

RESULTS

There were 185 participants (47.4%) had visceral obesity. The positive rate of TPOAb was significantly higher in T2DM patients with visceral obesity (12.97% vs 5.37%, p < 0.01). Free triiodothyronine (FT3) and thyroid-stimulating hormone (TSH) were both significantly higher in T2DM patients with visceral obesity (p < 0.05). The increased TPOAb titer was significantly positively correlated with visceral fat area (r = 0.175, p < 0.01). Binary logistic analysis showed that the positive rate of TPOAb was associated with an increased risk of visceral obesity [(OR) 4.258, 95% confidence interval (CI) 1.594, 11.375, p = 0.004].

CONCLUSION

TPOAb-positive is more common in T2DM patients with visceral obesity, which has some effects on visceral obesity independent of thyroid function. This suggests that elevated TPOAb titer is a predictor of visceral obesity in T2DM patients.

摘要

目的

肥胖和自身免疫性甲状腺疾病(AITD)在普通人群中都是常见疾病,是不良健康状况的主要驱动因素。虽然甲状腺功能与内脏肥胖之间被认为存在相互作用,但很少有研究探讨AITD与内脏肥胖之间的关系,尤其是在2型糖尿病(T2DM)患者中。在本研究中,我们调查了T2DM患者甲状腺过氧化物酶抗体(TPOAb)滴度升高与内脏脂肪面积之间的关联。

方法

本研究纳入了2020年4月至2020年12月期间符合入院标准并加入浙江省人民医院国家代谢管理中心(MMC)的390例T2DM患者。根据内脏肥胖情况将参与者分为两组。通过血液检测测量甲状腺功能、甲状腺相关抗体和其他代谢指标。通过生物电阻抗分析测量内脏脂肪面积(VFA)和皮下脂肪面积(SFA)。

结果

有185名参与者(47.4%)存在内脏肥胖。内脏肥胖的T2DM患者中TPOAb阳性率显著更高(12.97%对5.37%,p<0.01)。内脏肥胖的T2DM患者中游离三碘甲状腺原氨酸(FT3)和促甲状腺激素(TSH)均显著更高(p<0.05)。TPOAb滴度升高与内脏脂肪面积显著正相关(r = 0.175,p<0.01)。二元逻辑分析表明,TPOAb阳性率与内脏肥胖风险增加相关[比值比(OR)4.258,95%置信区间(CI)1.594,11.375,p = 0.004]。

结论

TPOAb阳性在伴有内脏肥胖的T2DM患者中更为常见,其对内脏肥胖有一定影响,且独立于甲状腺功能。这表明TPOAb滴度升高是T2DM患者内脏肥胖的一个预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da55/8938158/1878858e55a6/DMSO-15-863-g0001.jpg

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