摘要
目的了解更年期女性糖尿病患者亚临床甲状腺功能减退(简称"甲减")的患病情况及其影响因素,为防治亚临床甲减提供临床依据。方法于2014年1月至2017年1月,选取在保定市第一医院住院的349例更年期女性糖尿病患者为研究对象,根据促甲状腺激素(TSH)水平,分为甲状腺功能正常组(235例)和亚临床甲减组(114例)。测量入选患者身高、体重,计算体质指数(BMI);由专业医师询问患者闭经时间,并协助患者填写女性绝经期自测表(Kupperman改良评分,KI评分);测定患者血雌二醇(E2)、卵泡刺激素(FSH)、黄体生成素(LH)、促甲状腺激素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)、空腹血糖(FPG)、糖化血红蛋白(HbA_(1C))、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、血尿酸(SUA)和超敏C反应蛋白(hs-CRP)水平。采用SPSS 21.0统计软件进行t检验和χ~2检验,进行Pearson相关分析,亚临床甲减的影响因素采用多因素logistic回归分析。结果 349例更年期女性糖尿病患者亚临床甲减患病率为32.7%。两组患者年龄、BMI、闭经时间、FPG和TG比较,差异均无统计学意义(P>0.05);亚临床甲减组糖尿病病程、HbA_(1C)、TC、SUA和hs-CRP水平显著高于甲状腺功能正常组,HDL-C水平低于甲状腺功能正常组,差异均有统计学意义(P<0.05,P<0.01)。亚临床甲减组KI评分高于甲状腺功能正常组,感觉障碍、抑郁及疑心、眩晕、疲乏和肌肉关节痛症状发生率均高于甲状腺功能正常组,差异均有统计学意义(P<0.05)。亚临床甲减组的E2水平低于甲状腺功能正常组,FSH、LH和TSH水平高于甲状腺功能正常组,差异均有统计学意义(P<0.05,P<0.01)。Pearson相关分析结果显示,亚临床甲减与HbA_(1C)、hs-CRP和SUA呈正相关(r值分别为0.137、0.127和0.119),与HDL-C和E2呈负相关,均有统计学意义(r值分别为-0.113和-0.124,P<0.05)。多因素logistic回归分析结果显�
Objective To investigate the prevalence and influencing factors of diabetes mellitus plus subclinical hypothyroidism in the climacteric women and to provide the clinical basis for preventing and treating the subclinical hypothyroidism.Methods From January of 2014 to January of 2017,349 climacteric inpatients with diabetes in the first hospital of baoding city served as the subjects,who were divided into normal thyroid function group(n=235)and subclinical hypothyroidism group(n=144)according to TSH levels.The height,weight and BMI were measured and calculated;professional physicians inquired amenorrhea time and assisted the patients to fill the female menopause self-test form(Kupperman improvement score,KI score);the levels of serum estradiol 2(E2),follicle-stimulating hormone(FSH),luteinizing hormone(LH),free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH),fasting blood glucose(FPG),glycosylated hemoglobin(HbA1C),total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),blood uric acid(SUA),hypersensitive c-reactive protein(hs-CRP)were tested.The t test andχ2 test were used to analyze the data,the Pearson correlation analysis was used to analyze the correlation,the multivariate logistic regression analysis was used to analyze the influencing factors of subclinical hypothyroidism.Results In 349 subjects,the morbidity of diabetes plus subclinical hypothyroidism was 32.7%.There were no the significant differences of age,BMI,amenorrhea,FPG,and TG levels between the two groups(P>0.05);the diabetes duration,levels of HbA1C,TC,SUA and hs-CRP in subclinical hypothyroidism group were significantly higher than those in normal thyroid function group,but the level of HDL-C in subclinical hypothyroidism group was significantly lower than that in normal thyroid function group(P<0.05);the KI score,the incidences of abnormal sensation,depression,dizziness,fatigue and muscle joint pain in subclinical hypothyroidism group were significantly higher than those in normal thyroid f
作者
魏巍
谢小琪
刘静芹
WEI Wei;XIE Xiao-qi;LIU Jing-qin(Department of Endocrinology,the First Hospital of Baoding,Baoding,Hebei Province 071000,China;不详)
出处
《中国慢性病预防与控制》
CAS
CSCD
北大核心
2019年第2期93-96,101,共5页
Chinese Journal of Prevention and Control of Chronic Diseases
基金
河北省医学科学研究重点课题计划(20181476)
关键词
亚临床甲状腺功能减退
糖尿病
2型
更年期
影响因素
Subclinical hypothyroidism
Diabetes mellitus,type 2
Climacteric
Influencing factors
