Tianjin University of Traditional Chinese Medicine, Tianjin, China.
Second Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
Front Endocrinol (Lausanne). 2022 Jun 15;13:895843. doi: 10.3389/fendo.2022.895843. eCollection 2022.
Thyroid hormones influence glucose homeostasis through central and peripheral regulation. To date, the association between thyroid hormone sensitivity and elevated blood glucose (EBG) in patients with coronary heart disease (CHD) remains unknown. The purpose of this study was to investigate the association between thyroid hormone sensitivity and risk of EBG in patients with CHD, and to further explore their association in different sexes and ages.
This large multicenter retrospective study included 30,244 patients with CHD (aged 30-80 years) between 1 January 2014 and 30 September 2020. Parameters representing central and peripheral sensitivity to thyroid hormones were calculated. Central sensitivity to thyroid hormones was assessed by calculating the Thyroid Feedback Quantile-based Index (TFQI), Thyroid-stimulating Hormone Index (TSHI), and Thyrotropin Thyroxine Resistance Index (TT4RI), and Parametric Thyroid Feedback Quantile-based Index (PTFQI); peripheral sensitivity to thyroid hormones was evaluated using the ratio of free triiodothyronine (FT3) /free thyroxine (FT4). Taking normal glucose tolerance (NGT) as a reference, logistic regression was used to analyse the relationship between central and peripheral thyroid hormone sensitivity and EBG in patients with CHD.
Among the 30,244 participants, 15,493 (51.23%) had EBG. The risk of EBG was negatively correlated with TSHI (OR: 0.91; 95%CI: 0.91 to 0.92; < 0.001), TT4RI (OR: 0.99; 95% CI: 0.99 to 0.99; <0.001), TFQI (OR: 0.82; 95%CI: 0.80 to 0.84; 0.001) and PTFQI (OR: 0.76; 95%CI: 0.74 to 0.78; <0.001). Compared to males and patients aged 60 and below, the OR value for EBG was lower in females and in patients aged over 60 years old. Conversely, EBG risk was positively associated with FT3/FT4 (OR: 1.08; 95% CI: 1.07 to 1.09; 0.001) and in the sex-categorized subgroups, males had higher OR values than females.
This study showed that thyroid hormone sensitivity is significantly associated with EBG in patients with CHD. This association is higher in females than in males, and the association in those aged over 60 years old is higher than that in patients aged 60 years and below.
甲状腺激素通过中枢和外周调节影响血糖稳态。迄今为止，甲状腺激素敏感性与冠心病（CHD）患者高血糖（EBG）之间的关系尚不清楚。本研究旨在探讨 CHD 患者甲状腺激素敏感性与 EBG 风险的关系，并进一步探讨其在不同性别和年龄中的相关性。
这是一项大型多中心回顾性研究，纳入了 2014 年 1 月 1 日至 2020 年 9 月 30 日期间年龄在 30-80 岁的 30244 例 CHD 患者。计算了代表甲状腺激素中枢和外周敏感性的参数。通过计算甲状腺反馈定量指数（TFQI）、促甲状腺激素指数（TSHI）和促甲状腺素甲状腺素抵抗指数（TT4RI）来评估甲状腺激素的中枢敏感性，参数包括甲状腺刺激激素指数（TSHI）和促甲状腺素甲状腺素抵抗指数（TT4RI）；通过游离三碘甲状腺原氨酸（FT3）/游离甲状腺素（FT4）比值评估甲状腺激素外周敏感性。以正常糖耐量（NGT）为参考，采用 logistic 回归分析 CHD 患者中甲状腺激素中枢和外周敏感性与 EBG 之间的关系。
在 30244 名参与者中，有 15493 名（51.23%）存在 EBG。EBG 的风险与 TSHI（比值比[OR]：0.91；95%置信区间[CI]：0.91 至 0.92；<0.001）、TT4RI（OR：0.99；95%CI：0.99 至 0.99；<0.001）、TFQI（OR：0.82；95%CI：0.80 至 0.84；0.001）和 PTFQI（OR：0.76；95%CI：0.74 至 0.78；<0.001）呈负相关。与男性和 60 岁及以下的患者相比，女性和 60 岁以上的患者 EBG 的比值比（OR）值较低。相反，EBG 风险与 FT3/FT4（OR：1.08；95%CI：1.07 至 1.09；<0.001）呈正相关，且在性别分类亚组中，男性的 OR 值高于女性。
本研究表明，甲状腺激素敏感性与 CHD 患者的 EBG 显著相关。这种相关性在女性中高于男性，在 60 岁以上的患者中高于 60 岁及以下的患者。
