[1]袁 曦,刘浪浪,王 新,等.甲状腺功能正常的2型糖尿病患者血清促甲状腺激素水平与糖化血红蛋白达标相关性分析[J].陕西医学杂志,2022,51(3):303-307.[doi:DOI:10.3969/j.issn.1000-7377.2022.03.009]
　YUAN Xi,LIU Langlang,WANG Xin,et al.Correlation between serum TSH and standard-reaching of HbA1c in type 2 diabetic patients with normal thyroid function[J].,2022,51(3):303-307.[doi:DOI:10.3969/j.issn.1000-7377.2022.03.009]
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甲状腺功能正常的2型糖尿病患者血清促甲状腺激素水平与糖化血红蛋白达标相关性分析
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
51
期数:
2022年3期
页码:
303-307
栏目:
临床研究
出版日期:
2022-03-05

文章信息/Info

Title:
Correlation between serum TSH and standard-reaching of HbA1c in type 2 diabetic patients with normal thyroid function
作者:
袁 曦; 刘浪浪; 王 新; 王晓光; 赵国宏
(空军军医大学唐都医院内分泌科,陕西 西安 710038)
Author(s):
YUAN Xi; LIU Langlang; WANG Xin; WANG Xiaoguang; ZHAO Guohong
(Department of Endocrinology,Tangdu Hospital of Air Force Medical University,Xi'an 710038,China)
关键词:
2型糖尿病;  糖化血红蛋白;  促甲状腺激素;  达标率;  相关性
Keywords:
Type 2 diabetes;  HbA1c;  Thyroid stimulating hormone;  Standard-reaching rate;  Correlation
分类号:
R 587.1
DOI:
DOI:10.3969/j.issn.1000-7377.2022.03.009
文献标志码:
A
摘要:
目的:探讨甲状腺功能正常的2型糖尿病(T2DM)患者血清促甲状腺激素(TSH)水平与糖化血红蛋白(HbA1c)达标的相关性。方法:选取212例T2DM患者作为研究对象,收集基本资料,测量体重指数(BMI)、血压、血脂、HbA1c、TSH、血清游离三碘甲状腺原氨酸(FT3)、血清游离四碘甲状原氨酸(FT4)、甲状旁腺激素(PTH)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)及总胆固醇(TC)。根据HbA1c水平将患者分为血糖控制达标组(HbA1c<7%)和血糖控制不达标组(HbA1c≥7%),比较不同HbA1c水平T2DM患者一般资料及生化指标。采用Logistic回归分析不同TSH水平患者HbA1c达标的影响因素。根据TSH水平将患者进行四分位分组,比较不同TSH水平患者HbA1c达标率。采用受试者工作特征(ROC)曲线分析TSH对T2DM患者HbA1c不达标的预测价值。结果:血糖控制不达标组患者病程长于血糖控制达标组,TSH水平低于血糖控制达标组(均P<0.05)。Logistic回归分析结果显示,TSH为影响T2DM患者HbA1c达标的独立因素(P<0.05),进一步性别分层后发现男性人群TSH为影响HbA1c是否达标的独立因素[OR=1.467,P=0.034,95%置信区间(CI):1.024～2.103],而女性人群TSH与HbA1c达标无明显相关性(P=0.468)。随着TSH水平升高,HbA1c达标率呈上升趋势,且Q4组高于Q1组(P<0.05)。ROC曲线分析显示,TSH预测T2DM患者HbA1c不达标的曲线下面积(AUC)为0.602。结论:TSH是T2DM患者HbA1c是否达标的独立影响因素,其中男性T2DM患者TSH与HbA1c达标率呈正相关,女性T2DM患者TSH与HbA1c无明显相关。TSH对预测HbA1c是否达标有一定参考价值。
Abstract:
Objective:To investigate the relationship between serum thyroid stimulating hormone(TSH)and standard-reaching of hemoglobin A1c(HbA1c)in type 2 diabetes mellitus(T2DM)patients with normal thyroid function.Methods:A total of 212 patients with T2DM were selected as the research object.The basic data were collected,and the body mass index(BMI),blood pressure,blood lipid,HbA1c,TSH,serum FT3 and FT4,parathyroid hormone(PTH),triglyceride(TG),low density lipoprotein cholesterol(LDLC)and total cholesterol(TC)were measured.According to the level of HbA1c,the patients were divided into blood glucose control standard-reaching group(HbA1c<7%)and blood glucose control non-standard-reaching group(HbA1c≥7%).The general data and biochemical indexes of T2DM patients with different levels of HbA1c were compared.Logistic regression was used to analyze the influencing factors of standard-reaching of HbA1c in patients with different TSH levels.Patients were divided into quartiles according to TSH level,and the standard-reaching rate of HbA1c in patients with different TSH levels were compared.The subject operating characteristic(ROC)curve was used to analyze the predictive value of TSH for non-standard-reaching of HbA1c in T2DM patients.Results:The course of disease in the blood glucose control non-standard-reaching group was longer than that in the blood glucose control standard-reaching group,and the TSH level was lower than that in the blood glucose control standard-reaching group(all P<0.05).Logistic regression analysis showed that TSH was an independent factor affecting standard-reaching of HbA1c in T2DM patients(P<0.05).After further gender stratification,it was found that TSH in male population was an independent factor affecting standard-reaching of HbA1c(OR=1.467,P=0.034,95%CI:1.024-2.103),while TSH in female population had no significant correlation with standard-reaching of HbA1c(P=0.468).With the increase of TSH level,the standard-reaching rate of HbA1c increased,and group Q4 was higher than group Q1(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of non-standard-reaching of HbA1c predicted by TSH in T2DM patients was 0.602.Conclusion:TSH is an independent influencing factor of whether HbA1c has standard-reaching in T2DM patients.There is a positive correlation between TSH and standard-reaching rate of HbA1c in male T2DM patients,and there is no significant correlation between TSH and standard-reaching rate of HbA1c in female T2DM patients.TSH has certain reference value for predicting whether HbA1c has standard-reaching.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金青年科学基金资助项目(81502402)
更新日期/Last Update: 2022-03-04