新诊断2型糖尿病住院患者甲状腺特征及相关因素评估
Evaluation of the Thyroid Characteristics and Correlated Factors in Hospitalized Patients with Newly Diagnosed Type 2 Diabetes.
作者信息
Li Yanli, Yi Min, Deng Xiaoyi, Li Wangen, Chen Yimei, Zhang Xiaodan
机构信息
Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China.
Health Examination Department, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China.
出版信息
Diabetes Metab Syndr Obes. 2022 Mar 20;15:873-884. doi: 10.2147/DMSO.S355727. eCollection 2022.
BACKGROUND
Diabetes mellitus (DM) and thyroid dysfunction (TD) are two closely associated disorders. The objective of the present study was to investigate the thyroid status and the relationships between thyroid hormones, diabetic complications and metabolic parameters in hospitalized patients with newly diagnosed type 2 DM (T2DM).
METHODS
This was an observational cross-sectional study, conducting on 340 patients with newly diagnosed T2DM who were admitted to ward of endocrinology department and 120 matched individuals without diabetes. Anthropometric, clinical and biochemical data were collected. Spearman correlation coefficients were calculated to evaluate the correlations between thyroid hormones and other variables. Factors associated with diabetic nephropathy (DN) was analyzed with multivariate logistic regression.
RESULTS
Levels of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) were significantly lower in patients with T2DM as compared to control group without diabetes. The prevalence of TD was 21.2% in patients with diabetes, higher than that in controls (4.2%). The low T3 syndrome was the most frequent TD, shown in 14.7% of patients. The presence of diabetic complications DN, diabetic ketosis or ketoacidosis), metabolic and demographic factors, including age, glycemic control and insulin resistance were factors significantly associated with levels of thyroid hormones. FT3 level was inversely correlated with the level of urinary total protein (mg/24h) and the presence of DN. Multivariate analysis indicated low FT3 level as a strong independent risk factor (OR = 0.364, = 0.001) for DN.
CONCLUSION
TD is not rarely seen in hospitalized patients with newly diagnosed T2DM. Diabetic complications and diabetes-related metabolic and demographic factors are related to thyroid hormone levels. Decreased FT3 is strongly correlated with the presence of DN.
背景
糖尿病（DM）和甲状腺功能障碍（TD）是两种密切相关的疾病。本研究的目的是调查新诊断的2型糖尿病（T2DM）住院患者的甲状腺状况以及甲状腺激素、糖尿病并发症和代谢参数之间的关系。
方法
这是一项观察性横断面研究，对340例新诊断的T2DM患者进行研究，这些患者入住内分泌科病房，同时选取120例匹配的无糖尿病个体作为对照。收集人体测量学、临床和生化数据。计算Spearman相关系数以评估甲状腺激素与其他变量之间的相关性。采用多因素逻辑回归分析与糖尿病肾病（DN）相关的因素。
结果
与无糖尿病的对照组相比，T2DM患者的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）水平显著降低。糖尿病患者中TD的患病率为21.2%，高于对照组（4.2%）。低T3综合征是最常见的TD，在14.7%的患者中出现。糖尿病并发症（DN、糖尿病酮症或酮症酸中毒）、代谢和人口统计学因素，包括年龄、血糖控制和胰岛素抵抗是与甲状腺激素水平显著相关的因素。FT3水平与尿总蛋白水平（mg/24h）和DN的存在呈负相关。多因素分析表明低FT3水平是DN的一个强有力的独立危险因素（OR = 0.364，P = 0.001）。
结论
新诊断的T2DM住院患者中TD并不少见。糖尿病并发症以及与糖尿病相关的代谢和人口统计学因素与甲状腺激素水平有关。FT3降低与DN的存在密切相关。
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