叶酸缺乏可能会增加 2 型糖尿病患者 TSH 升高的风险。
Folate deficiency may increase the risk for elevated TSH in patients with type 2 diabetes mellitus.
机构信息
Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China.
出版信息
BMC Endocr Disord. 2023 Aug 11;23(1):169. doi: 10.1186/s12902-023-01422-2.
BACKGROUND
Type 2 diabetes mellitus (T2DM) and thyroid dysfunction (TD) are two common chronic endocrine disorders that often coexist. Folate deficiency has been reported to be related with the onset and development of T2DM. However, the relationship between folate deficiency and TD remains unclear. This study aims to investigate the association of serum folate with TD in patients with T2DM.
METHODS
The study used data on 268 inpatients with T2DM in the Beijing Chao-yang Hospital, Capital Medical University from October 2020 to February 2021. Thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), and serum folate were measured with chemiluminescence immunoassay (CLIA), and folate deficiency was defined as a serum folate concentration < 4.4 ng/mL. Ordinary least squares regression models were used to assess the association of serum folate with TSH concentration. Multivariable logistic regression models were performed to explore the correlation of folate deficiency and the risk for elevated TSH.
RESULTS
15.3% of T2DM patients had TD. Among those patients with TD, 80.5% had elevated TSH. Compared with the normal-TSH and low-TSH groups, the prevalence of folate deficiency was significantly higher in the elevated-TSH group (P < 0.001). Serum folate level was negatively associated with TSH (β=-0.062, 95%CI: -0.112, -0.012). Folate deficiency was associated with the higher risk for elevated TSH in patients with T2DM (OR = 8.562, 95%CI: 3.108, 23.588).
CONCLUSIONS
A low serum folate concentration was significantly associated with a higher risk for elevated TSH among T2DM patients.
背景
2 型糖尿病（T2DM）和甲状腺功能障碍（TD）是两种常见的慢性内分泌疾病，常并存。叶酸缺乏与 T2DM 的发生和发展有关。然而，叶酸缺乏与 TD 之间的关系尚不清楚。本研究旨在探讨 T2DM 患者血清叶酸与 TD 的关系。
方法
本研究使用了 2020 年 10 月至 2021 年 2 月首都医科大学附属北京朝阳医院 268 例住院 T2DM 患者的数据。采用化学发光免疫法（CLIA）检测促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）和血清叶酸，将血清叶酸浓度<4.4ng/ml 定义为叶酸缺乏。采用普通最小二乘回归模型评估血清叶酸与 TSH 浓度的关系。采用多变量 logistic 回归模型探讨叶酸缺乏与 TSH 升高风险的相关性。
结果
15.3%的 T2DM 患者存在 TD。在 TD 患者中，80.5%的 TSH 升高。与正常 TSH 和低 TSH 组相比，TSH 升高组叶酸缺乏的患病率显著更高（P<0.001）。血清叶酸水平与 TSH 呈负相关（β=-0.062，95%CI：-0.112，-0.012）。叶酸缺乏与 T2DM 患者 TSH 升高的风险增加相关（OR=8.562，95%CI：3.108，23.588）。
结论
血清叶酸浓度低与 T2DM 患者 TSH 升高的风险显著相关。
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