摘要
目的探讨甲状腺功能正常成人血清游离三碘甲状腺原氨酸(FT3)与C肽胰岛素抵抗指数(HOMA2 IR-CP)的相关性。方法横断面研究。回顾性分析2019年1至12月在解放军总医院第二医学中心体检的甲状腺功能正常成人的临床资料。根据HOMA2 IR-CP水平分为HOMA2 IR-CP>2.18组(n=3463)和HOMA2 IR-CP≤2.18(n=8204)组。采用单因素Pearson相关分析及多因素logistic回归分析FT3与HOMA2 IR-CP的相关性,采用交互作用模型分析FT3与相关因素之间的交互作用,采用限制性立方样条图探索连续性变量FT3与HOMA2 IR-CP的剂量-反应关系。结果依据纳排标准共纳入11667名甲状腺功能正常成人,男7756名,女3911名,年龄(50.7±10.0)岁。HOMA2 IR-CP>2.18组男性比例、体质指数、收缩压、糖化血红蛋白、空腹血糖、甘油三酯、血红蛋白、丙氨酸转氨酶、FT3水平显著高于HOMA2 IR-CP≤2.18组(均P<0.05),低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、游离甲状腺素低于HOMA2 IR-CP≤2.18组(均P<0.001)。单因素Pearson相关分析显示,FT3与HOMA2 IR-CP相关(r=0.21,P<0.001)。多因素logistic回归分析显示,在调整混杂因素后,FT3与HOMA2 IR-CP存在相关性(P_(趋势)<0.001)。亚组分析显示,不同性别、年龄、糖代谢状态亚组FT3与HOMA2 IR-CP均存在相关性(P_(趋势)<0.05)。相乘交互分析显示,FT3与年龄存在交互作用(P_(交互)<0.001)。限制性立方样条图分析显示,FT3与HOMA2 IR-CP呈线性相关(P_(整体)<0.001,P_(非线性)=0.479)。结论甲状腺功能正常成人血清FT3与HOMA2 IR-CP存在相关性。随着FT3水平升高,胰岛素抵抗程度逐渐加重。
Objective To explore the correlation between serum free triiodothyronine(FT3)and C-peptide-based insulin resistance index(HOMA2 IR-CP)in euthyroid adults.Methods A cross-sectional study.The clinical data of euthyroid adult participants who underwent physical examination in the Second Medical Center of Chinese PLA General Hospital from January to December in 2019 were retrospectively analyzed.According to the HOMA2 IR-CP level,the participants were divided into HOMA2 IR-CP>2.18 group(n=3463)and HOMA2 IR-CP≤2.18 group(n=8204).Univariate Pearson correlation analysis and multivariate logistic regression analysis were used to analyze the correlation between FT3 and HOMA2 IR-CP.The interaction model was used to analyze the interaction between FT3 and related factors,and the dose-response relationship between continuity variable FT3 and HOMA2 IR-CP was explored by using restricted cubic spline plots.Results A total of 11667 euthyroid adult participants aged(50.7±10.0)years were recruited according to the inclusion and exclusion criteria,with 7756 males and 3911 females.The proportion of males,body mass index,systolic blood pressure,glycated hemoglobin A1c,fasting plasma glucose,triglyceride,hemoglobin,alanine aminotransferase and FT3 levels in HOMA2 IR-CP>2.18 group were significantly higher than those in HOMA2 IR-CP≤2.18 group(all P<0.05).The levels of low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,and free thyroxine in HOMA2 IR-CP>2.18 group were lower than those in HOMA2 IR-CP≤2.18 group(all P<0.001).Univariate Pearson correlation analysis showed that FT3 was associated with HOMA2 IR-CP(r=0.21,P<0.001).Multivariate logistic regression analysis suggested an association between FT3 and HOMA2 IR-CP after adjusting for confounding factors(P_(for trend)<0.001).Subgroup analysis showed an association between FT3 and HOMA2 IR-CP in different subgroups of gender,age and glucose metabolism status(P_(for trend)<0.05).Multiplication interaction analysis suggested that there was an interaction between FT3 and age(P_(interaction)<0.001).Restricted cubic spline model analysis demonstrated that the correlation between FT3 and HOMA2 IR-CP was linear(P_(overall)<0.001,P_(nonlinear)=0.479).Conclusions There is a correlation between serum FT3 and HOMA2 IR-CP in euthyroid adults.With the increase of FT3 level,insulin resistance increases gradually.
作者
王宁
王薇
刘星宇
罗艺
孙般若
闫双通
方福生
Wang Ning;Wang Wei;Liu Xingyu;Luo Yi;Sun Banruo;Yan Shuangtong;Fang Fusheng(Department of Health Management,the Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Health Care,the Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Endocrinology,the Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2024年第28期2626-2631,共6页
National Medical Journal of China
基金
军队保健专项科研课题(22BJZ33)
作者简介
王宁,对本文有同等贡献;王薇,对本文有同等贡献;通信作者:方福生,Email:fangfs78@163.com
