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目的探讨甲状腺功能正常的T2DM患者血清甲状腺激素与血糖、血脂等的关系。方法 291例T2DM患者,测定FPG、HbA1c、血脂、UA及甲状腺激素。结果按HbA1c水平分为三组,不同组间的促甲状腺素(TSH)之间差异有统计学意义(P<0.01),HbA1c≥11%组的游离三碘甲状腺原氨酸(FT3)显著低于另两组(P<0.05);按不同TSH水平分为三组,不同组间的TC及TG之间差异有统计学意义(P<0.01);与0.5～1.5mU/L组相比,2.5～5.0mU/L组的LDL-C、UA显著升高(P<0.05);TSH与HbA1c呈负相关性(r=-0.123,P<0.05),与TG、TC、LDL-C、UA呈正相关性(r=0.186、0.134、0.121、0.148,P<0.05),三碘甲腺原氨酸(TT3)与TC、LDL-C呈正相关性(r=0.170、0.178,P<0.01),与UA呈负相关性(r=-0.117,P<0.05),FT3与HbA1c、FPG、年龄呈负相关性(r=-0.15、-0.120、-0.226,P<0.05)。年龄、FPG是影响FT3变化的独立因素(OR=-0.192、0.272,P<0.01)。结论甲状腺激素水平对评估T2DM患者糖、脂及嘌呤代谢有重要意义。
Objective To investigate the relationship between serum thyroid hormones and blood glucose, blood lipids in T2DM patients with normal thyroid function. Methods 291 T2DM patients were tested for FPG, HbA1c, lipids, UA and thyroid hormones. The results were divided into three groups according to the level of HbA1c. There was significant difference between TSH in different groups (P <0.01), and the FT3 in HbA1c≥11% group was significantly lower (P <0.05). The levels of TC and TG in different groups were statistically different (P <0.01), and were different in three groups according to different TSH levels. Compared with 0.5 ~ 1.5mU / L group, LDL-C and UA in 2.5 ~ 5.0mU / L group were significantly increased (P <0.05); TSH was negatively correlated with HbA1c (r = -0.123, P < (R = 0.186,0.134,0.121,0.148, P <0.05), TT3 was positively correlated with TC and LDL-C (r = 0.170,0.178, P <0.01) (R = -0.117, P <0.05). There was a negative correlation between FT3 and HbA1c, FPG and age (r = -0.15, -0.120, -0.226, P <0.05). Age and FPG were the independent factors affecting the changes of FT3 (OR = -0.192,0.272, P <0.01). Conclusions Thyroid hormone levels are important for the assessment of glucose, lipid and purine metabolism in patients with T2DM.