促甲状腺激素水平升高与糖尿病性黄斑水肿相关：一项2型糖尿病患者的横断面研究。

A high TSH level is associated with diabetic macular edema: a cross-sectional study of patients with type 2 diabetes mellitus.

作者信息

Cao Xi, Lu Ming, Xie Rong-Rong, Song Li-Ni, Yang Wei-Li, Xin Zhong, Yang Guang-Ran, Yang Jin-Kui

机构信息

Beijing Diabetes Institute, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

出版信息

Endocr Connect. 2022 Jun 29;11(7). doi: 10.1530/EC-22-0122. Print 2022 Jul 1.

DOI:10.1530/EC-22-0122

PMID:35686715

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9254322/

Abstract

AIMS

In this study, we determined the association between thyroid-stimulating hormone (TSH) and diabetic macular edema (DME) by assessing the prevalence and risk factors for DME in type 2 diabetes mellitus (T2DM) patients with different thyroid dysfunctions.

METHODS

This was a retrospective cross-sectional study including 1003 euthyroid and 92 subclinical hypothyroidism (SCH) T2DM patients. DME status was detected by optical coherence tomography (OCT). The association between TSH and DME and the impact of TSH on DME were analyzed.

RESULTS

The DME prevalence was 28.3% in the SCH patients and 14.0% in the euthyroid population. The serum FT4 (P = 0.001) and FT3 (P < 0.001) levels were significantly higher in the non-DME group than in the DME group, and the TSH level (P < 0.001) was significantly lower. Four subgroups (G1-G4) were divided by TSH level, and the chi-square test indicated that even in the normal range, the TSH level was positively related to DME prevalence (P = 0.001). Subgroup data indicated that the association between TSH and DME detected by OCT (P = 0.001) was stronger than the correlation between TSH and diabetic retinopathy detected by digital retinal photographs (P = 0.027). The logistic regression model confirmed that elevated TSH was an independent risk factor for DME. The odds ratio was 1.53 (P = 0.02).

CONCLUSIONS

A high TSH level was an independent risk factor for DME. More attention should be given to the TSH level in T2DM patients due to its relationship with diabetic complications.

摘要

目的

在本研究中，我们通过评估不同甲状腺功能障碍的2型糖尿病（T2DM）患者中糖尿病性黄斑水肿（DME）的患病率和危险因素，确定促甲状腺激素（TSH）与DME之间的关联。

方法

这是一项回顾性横断面研究，纳入了1003例甲状腺功能正常和92例亚临床甲状腺功能减退（SCH）的T2DM患者。通过光学相干断层扫描（OCT）检测DME状态。分析TSH与DME之间的关联以及TSH对DME的影响。

结果

SCH患者中DME患病率为28.3%，甲状腺功能正常人群中为14.0%。非DME组的血清游离甲状腺素（FT4，P = 0.001）和游离三碘甲状腺原氨酸（FT3，P < 0.001）水平显著高于DME组，而TSH水平（P < 0.001）显著更低。根据TSH水平分为四个亚组（G1 - G4），卡方检验表明，即使在正常范围内，TSH水平与DME患病率呈正相关（P = 0.001）。亚组数据表明，通过OCT检测到的TSH与DME之间的关联（P = 0.001）比通过数字视网膜照片检测到的TSH与糖尿病视网膜病变之间的相关性更强（P = 0.027）。逻辑回归模型证实，TSH升高是DME的独立危险因素。比值比为1.53（P = 0.02）。