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尼日利亚西南部一家农村医疗机构中2型糖尿病患者的甲状腺功能测试范围:一项基于医院的研究。

Spectrum of thyroid function test among type 2 diabetic patients attending a rural health facility, southwest Nigeria: A hospital-based study.

作者信息

Jimoh Ahmed Kayode, Ghazali Muritala Segun, Ogundeji Olajumoke Ajele, Adeleke Babajide Adewoyin, Ajani Oladimeji Gbadebo, Gabriel-Alayode Emmanuel Olusegun, Popoola Gbenga Omotade, Adediran Olufemi Sola

机构信息

Department of Chemical Pathology, Afe Babalola University, Ado-Ekiti, Nigeria.

Department of Chemical Pathology, Federal Teaching Hospital, Ido-Ekiti, Nigeria.

出版信息

SAGE Open Med. 2022 May 13;10:20503121221097625. doi: 10.1177/20503121221097625. eCollection 2022.

Abstract

OBJECTIVES

The thyroid gland produces hormones that have significant influence on carbohydrate metabolism; its disorders may affect carbohydrate metabolism in type 2 diabetic patients (T2DM) more than the non-diabetic (NDM) patients as reported in various studies. We determined the spectrum of thyroid function tests (TFTs) profile among T2DM in our rural health facility.

METHODS

T2DM patients and NDM patients were recruited for the study. The age, educational level, occupation, marital status, and duration of diabetes were extracted from interviewer's administered questionnaire. The weight, height, body mass indices (BMIs), and the waist and hip circumferences were measured. Waist-hip ratios (WHR) were calculated for all participants. Venous blood was collected and assayed for free triiodothyronine (fT3), free thyroxine (fT4), and thyroid stimulating hormone (TSH) using a Chemiluminescence Immunoassay (CLIA) 2nd Generation Autoanalyzer. The mean, standard deviation, frequencies, and percentages were calculated for the variables. The student's t-test and chi-square test were also determined as appropriate.

RESULTS

Seventy-eight patients made up of 56 T2DM and 22 NDM were evaluated in this study. Fifty-one were males while 27 were females; 67.9% and 59.1% of the female participants were T2DM and NDM, respectively. The WHR was significantly higher in T2DM than NDM (0.92 ± 0.05 versus 0.88 ± 0.06). The TSH was higher in T2DM than the NDM. Forty-four (78.6%) of the T2DM had euthyroid (normal) biochemical pattern; 12 (21.4%) showed abnormal biochemical pattern of euthyroid sick syndrome, subclinical hyperthyroid, and subclinical hypothyroid. Thirty (53.6%) of the T2DM were diagnosed less than five years ago. The value of TSH was increasing with the duration of diabetes but not in a statistically significant way. None of the T2DM showed overt hypothyroid or hyperthyroid test result.

CONCLUSION

Thyroid function test may identify diabetics with altered thyroid hormone status that may impact on their metabolic control. Knowledge of the functional state of the thyroid gland can help in achieving a better metabolic control and attenuate the development of complications in T2DM.

摘要

目的

甲状腺产生的激素对碳水化合物代谢有重大影响;如各项研究报道,其功能紊乱对2型糖尿病患者(T2DM)碳水化合物代谢的影响可能比对非糖尿病患者(NDM)更大。我们在我们的农村卫生机构中确定了T2DM患者的甲状腺功能测试(TFTs)谱。

方法

招募T2DM患者和NDM患者进行研究。通过访员管理的问卷提取年龄、教育程度、职业、婚姻状况和糖尿病病程。测量体重、身高、体重指数(BMI)以及腰围和臀围。计算所有参与者的腰臀比(WHR)。采集静脉血,使用第二代化学发光免疫分析自动分析仪(CLIA)检测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)。计算变量的均值、标准差、频率和百分比。还酌情进行了学生t检验和卡方检验。

结果

本研究评估了78例患者,其中56例T2DM患者和22例NDM患者。51例为男性,27例为女性;女性参与者中分别有67.9%和59.1%为T2DM和NDM。T2DM患者的WHR显著高于NDM患者(0.92±0.05对0.88±0.06)。T2DM患者的TSH高于NDM患者。44例(78.6%)T2DM患者甲状腺功能正常(生化模式正常);12例(21.4%)表现出甲状腺功能正常病态综合征、亚临床甲状腺功能亢进和亚临床甲状腺功能减退的异常生化模式。30例(53.6%)T2DM患者在不到五年前被诊断出来。TSH值随糖尿病病程增加,但无统计学意义。所有T2DM患者均未出现明显的甲状腺功能减退或亢进检测结果。

结论

甲状腺功能测试可能识别出甲状腺激素状态改变的糖尿病患者,这可能会影响他们的代谢控制。了解甲状腺的功能状态有助于实现更好的代谢控制,并减轻T2DM患者并发症的发生。

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本文引用的文献

1
Risk Factors of Thyroid Dysfunction in Patients With Type 2 Diabetes Mellitus.2型糖尿病患者甲状腺功能障碍的危险因素
Front Endocrinol (Lausanne). 2019 Jul 4;10:440. doi: 10.3389/fendo.2019.00440. eCollection 2019.
7
Prevalence of thyroid dysfunction among type 2 diabetes mellitus patients.2型糖尿病患者中甲状腺功能障碍的患病率。
Diabetes Metab Syndr. 2017 Nov;11 Suppl 1:S105-S108. doi: 10.1016/j.dsx.2016.12.017. Epub 2016 Dec 19.

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