【摘要】：目的：通過回顧性資料分析甲狀腺功能正常的2型糖尿病患者中不同TSH水平與頸動脈內(nèi)膜中層厚度的關(guān)系。方法：收集2013年12月至2016年1月于廣西醫(yī)科大學(xué)第一附屬醫(yī)院內(nèi)分泌科住院病人,共364例甲狀腺功能正常的2型糖尿病患者。(1)根據(jù)頸動脈內(nèi)中膜厚度(IMT)分三組：IMT正常組、IMT單純增厚組、頸動脈斑塊組,比較三組間性別、年齡、病程、吸煙、血壓、體重指數(shù)(BMI)、空腹血糖(FPG)、餐后2小時(shí)血糖(PPG)、糖化血紅蛋白(HbA1c)、甘油三酯(TG)、總膽固醇(TC)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)、同型半胱氨酸(HCY)、總蛋白(TP)、24h尿微量白蛋白之間的差異。(2)根據(jù)血清TSH水平的實(shí)際測量值運(yùn)用三分位數(shù)分為三組：高TSH組、中TSH組及低TSH組,比較三組間性別、年齡、病程、吸煙、血壓、BMI、血糖、]EbA1c、 TG、TC、HDL-C、LDL-C、HCY、TP、24h尿微量白蛋白、IMT的差異,同時(shí)比較三組間在0個(gè)斑塊、1個(gè)斑塊、≥2個(gè)斑塊的檢出率。結(jié)果：1.IMT單純增厚組PPG、TC、LDL-C顯著高于IMT正常組(P0.05)；斑塊組年齡、病程、收縮壓、HCY顯著高于IMT正常組(P0.05),TC、LDL-C水平顯著低于IMT正常組(P0.05);頸動脈斑塊組的年齡、病程、HCY顯著高于IMT單純增厚組(P0.05),而PPG、TC、LDL-C水平顯著低于IMT單純增厚組(P0.05)。2.高TSH組的TC、TG、LDL-C、IMT水平均顯著增高于中TSH組和低TSH組(P0.05)；三組間的斑塊檢出率差異無統(tǒng)計(jì)學(xué)意義。3.Person相關(guān)性分析發(fā)現(xiàn),IMT與年齡、病程、TSH、HCY、TC、LDL-C呈正相關(guān),與TT3呈負(fù)相關(guān)(P0.05)。4.偏相關(guān)分析顯示TSH與IMT在2型糖尿病患者中呈顯著正相關(guān),并獨(dú)立于年齡、病程、TT3、HCY、TC、LDL-C等因素。5.多元線性回歸分析顯示年齡、TSH是影響IMT的獨(dú)立危險(xiǎn)因素。結(jié)論：1.在甲狀腺功能正常的2型糖尿病患者中,隨著TSH水平的升高,TC、 TG、LDL-C、IMT呈遞增趨勢。2.在甲狀腺功能正常的2型糖尿病患者中,年齡、TSH是影響IMT的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective: to analyze the relationship between different TSH levels and carotid intima-media thickness in patients with type 2 diabetes mellitus with normal thyroid function. Methods: a total of 364patients with type 2 diabetes mellitus with normal thyroid function were collected from December 2013 to January 2016 in the Department of Endocrinology, the first affiliated Hospital of Guangxi Medical University. (1) according to the intima-media thickness of carotid artery, (IMT) was divided into three groups: normal IMT group, IMT thickening group and carotid plaque group. Sex, age, course of disease, smoking, blood pressure and body mass index (BMI), fasting blood glucose (FPG), were compared among the three groups. The differences of postmeal blood glucose (PPG), glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and homocysteine (HCY), total protein (TP), 24 h urinary microalbumin. (2) according to the actual measured value of serum TSH level, they were divided into three groups: high TSH group, In middle TSH group and low TSH group, the differences of sex, age, course of disease, smoking, blood pressure, BMI, blood glucose,] EbA1c, TG,TC,HDL-C,LDL-C,HCY,TP,24h urinary microalbumin and IMT were compared among the three groups, and the detection rates of 0 plaques, 1 plaque and 鈮，

本文編號：2512678