Wang N, Wang W, Liu X Y, Luo Y, Sun B R, Yan S T, Fang F S
Department of Health Management, the Second Medical Center, Chinese PLA General Hospital, Beijing 100853, China.
Department of Health Care, the Second Medical Center, Chinese PLA General Hospital, Beijing 100853, China.
Zhonghua Yi Xue Za Zhi. 2024 Jul 23;104(28):2626-2631. doi: 10.3760/cma.j.cn112137-20231205-01298.
To explore the correlation between serum free triiodothyronine (FT3) and C-peptide-based insulin resistance index (HOMA2 IR-CP) in euthyroid adults. A cross-sectional study. The clinical data of euthyroid adult participants who underwent physical examination in the Second Medical Center of Chinese PLA General Hospital from January to December in 2019 were retrospectively analyzed. According to the HOMA2 IR-CP level, the participants were divided into HOMA2 IR-CP>2.18 group (=3 463) and HOMA2 IR-CP≤2.18 group (=8 204). Univariate Pearson correlation analysis and multivariate logistic regression analysis were used to analyze the correlation between FT3 and HOMA2 IR-CP. The interaction model was used to analyze the interaction between FT3 and related factors, and the dose-response relationship between continuity variable FT3 and HOMA2 IR-CP was explored by using restricted cubic spline plots. A total of 11 667 euthyroid adult participants aged (50.7±10.0)years were recruited according to the inclusion and exclusion criteria, with 7 756 males and 3 911 females. The proportion of males, body mass index, systolic blood pressure, glycated hemoglobin A1c, fasting plasma glucose, triglyceride, hemoglobin, alanine aminotransferase and FT3 levels in HOMA2 IR-CP>2.18 group were significantly higher than those in HOMA2 IR-CP≤2.18 group (all <0.05). The levels of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and free thyroxine in HOMA2 IR-CP>2.18 group were lower than those in HOMA2 IR-CP≤2.18 group (all <0.001). Univariate Pearson correlation analysis showed that FT3 was associated with HOMA2 IR-CP (=0.21, <0.001). Multivariate logistic regression analysis suggested an association between FT3 and HOMA2 IR-CP after adjusting for confounding factors(<0.001). Subgroup analysis showed an association between FT3 and HOMA2 IR-CP in different subgroups of gender, age and glucose metabolism status (<0.05). Multiplication interaction analysis suggested that there was an interaction between FT3 and age (<0.001). Restricted cubic spline model analysis demonstrated that the correlation between FT3 and HOMA2 IR-CP was linear (<0.001, =0.479). There is a correlation between serum FT3 and HOMA2 IR-CP in euthyroid adults. With the increase of FT3 level, insulin resistance increases gradually.
探讨甲状腺功能正常的成年人血清游离三碘甲状腺原氨酸(FT3)与基于C肽的胰岛素抵抗指数(HOMA2 IR-CP)之间的相关性。一项横断面研究。回顾性分析2019年1月至12月在中国人民解放军总医院第二医学中心接受体检的甲状腺功能正常的成年参与者的临床资料。根据HOMA2 IR-CP水平,将参与者分为HOMA2 IR-CP>2.18组(n = 3463)和HOMA2 IR-CP≤2.18组(n = 8204)。采用单因素Pearson相关性分析和多因素logistic回归分析来分析FT3与HOMA2 IR-CP之间的相关性。使用交互作用模型分析FT3与相关因素之间的交互作用,并通过限制立方样条图探讨连续性变量FT3与HOMA2 IR-CP之间是否存在剂量反应关系。根据纳入和排除标准,共招募了11667名年龄为(50.7±10.0)岁的甲状腺功能正常的成年参与者,其中男性7756名,女性3911名。HOMA2 IR-CP>2.18组的男性比例、体重指数、收缩压、糖化血红蛋白A1c、空腹血糖、甘油三酯、血红蛋白、丙氨酸氨基转移酶和FT3水平均显著高于HOMA2 IR-CP≤2.18组(均P<0.05)。HOMA2 IR-CP>2.18组的低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和游离甲状腺素水平低于HOMA2 IR-CP≤2.18组(均P<0.001)。单因素Pearson相关性分析显示,FT3与HOMA2 IR-CP相关(r = 0.21,P<0.001)。多因素logistic回归分析表明,在调整混杂因素后,FT3与HOMA2 IR-CP相关(P<0.001)。亚组分析显示,在性别、年龄和糖代谢状态的不同亚组中,FT3与HOMA2 IR-CP相关(P<0.05)。相乘交互作用分析表明,FT3与年龄之间存在交互作用(P<0.001)。限制立方样条模型分析表明,FT3与HOMA2 IR-CP之间的相关性呈线性(P<0.001,R2 = 0.479)。甲状腺功能正常的成年人血清FT3与HOMA2 IR-CP之间存在相关性。随着FT3水平的升高,胰岛素抵抗逐渐增加。