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抗高血压药物对甲状腺功能正常的2型糖尿病患者甲状腺功能的影响。

Effects of Antihypertensive Drugs on Thyroid Function in Type 2 Diabetes Patients With Euthyroidism.

作者信息

Yang Lijuan, Sun Xiuqin, Zhao Yi, Tao Hong

机构信息

Department of Endocrinology and Metabolism, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

出版信息

Front Pharmacol. 2022 Mar 7;13:802159. doi: 10.3389/fphar.2022.802159. eCollection 2022.

Abstract

There is little literature about whether antihypertensive drugs would affect thyroid function in patients with euthyroid type 2 diabetes, which was significant in maintaining a proper balance of thyroid function. A retrospective cohort study was conducted to evaluate the influence of antihypertensive drugs on thyroid function in patients with type 2 diabetes with euthyroidism. The study involved dividing 698 patients with antihypertensive monotherapy into five groups according to the antihypertensive drugs they were treated with. Antihypertensive drugs included in this study were β-blockers, angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and calcium channel blockers (CCB). The clinical data and thyroid function level between or within groups were compared. Multiple logistic regression analysis was conducted to evaluate the association of antihypertensive drugs with thyroid function level. Selective β- adrenergic receptor blockers treatment was related to thyroid-stimulating hormone (TSH), increasing in patients with diabetes and euthyroidism as shown by multiple logistic regression analysis. The association existed after adjustment for confounding factors. No significant influence on thyroid function was found among other antihypertensive drugs. These data show the TSH-lifting effect of selective β-adrenergic receptor blockers in patients with type 2 diabetes with euthyroidism.

摘要

关于降压药物是否会影响甲状腺功能正常的2型糖尿病患者的甲状腺功能,相关文献较少,而维持甲状腺功能的适当平衡具有重要意义。本研究进行了一项回顾性队列研究,以评估降压药物对甲状腺功能正常的2型糖尿病患者甲状腺功能的影响。该研究将698例接受单一降压治疗的患者根据所使用的降压药物分为五组。本研究纳入的降压药物包括β受体阻滞剂、血管紧张素转换酶抑制剂(ACEI)、血管紧张素受体阻滞剂(ARB)和钙通道阻滞剂(CCB)。比较了组间和组内的临床资料及甲状腺功能水平。进行多因素logistic回归分析以评估降压药物与甲状腺功能水平的关联。多因素logistic回归分析显示,选择性β肾上腺素能受体阻滞剂治疗与促甲状腺激素(TSH)有关,在甲状腺功能正常的糖尿病患者中TSH升高。在对混杂因素进行校正后,这种关联依然存在。未发现其他降压药物对甲状腺功能有显著影响。这些数据表明,选择性β肾上腺素能受体阻滞剂对甲状腺功能正常的2型糖尿病患者有升高TSH的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bb3/8940167/1b91bee5a9bd/fphar-13-802159-g001.jpg

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