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成人隐匿性自身免疫性糖尿病患者甲状腺功能障碍的临床特征及相关危险因素:中国江苏徐州的一项单中心横断面研究

Clinical Characteristics and Related Risk Factors of Thyroid Dysfunction in LADA Patients: A Single-Center Cross-Sectional Study in Xuzhou, Jiangsu, China.

作者信息

Peng Dan, Zhang Hua, Xu Cheng, Wei Jing, Lu Qian

机构信息

Department of Endocrinology,Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China.

Department of Geriatrics, Shangzhou District People's Hospital, Shangluo, Shaanxi, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2025 Sep 8;18:3315-3321. doi: 10.2147/DMSO.S547172. eCollection 2025.

Abstract

OBJECTIVE

The aim of our study was to further explore the clinical characteristics and related risk factors of thyroid dysfunction in latent autoimmune diabetes in adults (LADA) patients in the Xuzhou region of Jiangsu, China, to facilitate early intervention and treatment.

METHODS

It is conducted a single-center, cross-sectional study involving 95 hospitalized LADA patients from the Affiliated Hospital of Xuzhou Medical University between January 2024 and April 2025. The patients were divided into two groups based on the presence of thyroid dysfunction: 39 LADA patients without thyroid dysfunction and 56 LADA patients with thyroid dysfunction. Data collection included clinical indicators and thyroid function assessments. Correlation analysis and univariate binary logistic regression analysis were performed on the study data.

RESULTS

Significant differences were observed between the two groups in urinary albumin-to-creatinine ratio (UACR), fasting C-peptide (FCP), postprandial 2-hour C-peptide (P2hCP), free triiodothyronine (FT3), free thyroxine (FT4), thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TGAb), thyrotropin receptor antibody (TRAb), and insulin autoantibody (IAA). Correlation analysis revealed that FCP was positively correlated with P2hCP and FT3 but negatively correlated with IAA. FT3 was positively correlated with P2hCP and FT4. TPOAb was positively correlated with TGAb and TRAb. Univariate binary logistic regression analysis indicated that low levels of FCP, P2hCP, and FT3, as well as high levels of TPOAb and TGAb, were associated with thyroid dysfunction in LADA patients.

CONCLUSION

Lower FCP, P2hCP, and FT3 levels, along with higher TPOAb and TGAb levels, are associated with thyroid dysfunction in LADA patients. Therefore, it is recommended that LADA patients undergo screening for thyroid antibodies and FT3 at disease onset and every 1-2 years thereafter to minimize the risk of undiagnosed thyroid dysfunction. Additionally, reassessment of pancreatic function every 3-6 months is advised to optimize the timing of insulin therapy.

摘要

目的

本研究旨在进一步探讨中国江苏徐州地区成人隐匿性自身免疫性糖尿病(LADA)患者甲状腺功能障碍的临床特征及相关危险因素,以促进早期干预和治疗。

方法

进行了一项单中心横断面研究,纳入了2024年1月至2025年4月徐州医科大学附属医院的95例住院LADA患者。根据是否存在甲状腺功能障碍将患者分为两组:39例无甲状腺功能障碍的LADA患者和56例有甲状腺功能障碍的LADA患者。数据收集包括临床指标和甲状腺功能评估。对研究数据进行相关性分析和单因素二元逻辑回归分析。

结果

两组在尿白蛋白与肌酐比值(UACR)、空腹C肽(FCP)、餐后2小时C肽(P2hCP)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、促甲状腺素受体抗体(TRAb)和胰岛素自身抗体(IAA)方面存在显著差异。相关性分析显示,FCP与P2hCP和FT3呈正相关,但与IAA呈负相关。FT3与P2hCP和FT4呈正相关。TPOAb与TGAb和TRAb呈正相关。单因素二元逻辑回归分析表明,低水平的FCP、P2hCP和FT3,以及高水平的TPOAb和TGAb与LADA患者的甲状腺功能障碍有关。

结论

较低的FCP、P2hCP和FT3水平,以及较高的TPOAb和TGAb水平与LADA患者的甲状腺功能障碍有关。因此,建议LADA患者在疾病发作时及此后每1 - 2年进行甲状腺抗体和FT3筛查,以降低未诊断甲状腺功能障碍的风险。此外,建议每3 - 6个月重新评估胰腺功能,以优化胰岛素治疗时机。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f82/12430241/b6280b1c48f7/DMSO-18-3315-g0001.jpg

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