摘要
目的探讨老年2型糖尿病患者甲状腺功能与非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)的相关性。方法本研究回顾分析2016年3月~2018年12月北京大学人民医院老年科就诊的甲状腺功能正常的老年2型糖尿病患者519例,其中60~69岁109例、70~79岁131例、年龄≥80岁279例,根据腹部彩色超声检查结果分为NAFLD组221例和非NAFLD组298例。收集入选者一般临床资料,血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)、γ谷氨酰转移酶(GGT)、总蛋白、白蛋白、血脂、尿酸、糖化血红蛋白(HbA1c)水平及估算肾小球滤过率(eGFR),进行血清三碘甲状腺原氨酸(TT3)、游离三碘甲状腺原氨酸(FT3)、促甲状腺激素(TSH)等甲状腺功能检查,采用多因素logistic回归分析危险因素。结果NAFLD患病率为42.6%,60~69岁、70~79岁、≥80岁NAFLD患病率明显降低(66.1%vs 42.7%vs 33.3%,P<0.05)。NAFLD组年龄、直接胆红素明显低于非NAFLD组,体质量指数、血清总蛋白、白蛋白、尿酸、HbA1c、eGFR、TC、TG、LDL-C、FT3、TT3及TSH明显高于非NAFLD组,差异有统计学意义(P<0.05,P<0.01)。logistic回归分析显示,年龄(OR=0.945,95%CI:0.917~0.973,P=0.000)、体质量指数(OR=1.150,95%CI:1.057~1.251,P=0.001)、TG(OR=2.615,95%CI:1.767~3.868,P=0.000)和TSH(OR=1.428,95%CI:1.016~2.006,P=0.040)是NAFLD发生的独立危险因素。结论在甲状腺功能正常的老年2型糖尿病患者中,TSH水平可能与NAFLD的发病独立相关。
Objective To study the association between thyroid function(TSH)and nonalcoholic fatty liver disease(NAFLD)in type 2 DM patients.Methods Five hundred and nineteen≥60 years old type 2 DM patients with normal thyroid function admitted to our hospital from March 2016 to December 2018 were divided into NAFLD group(n=221)and NAFLD-free group(n=298)according to their abdominal color ultrasonography.Their general clinical data were recorded,their serum levels of ALT,AST,ALP,GGT,total protein,albumin,blood lipids,UA,HbA1 c,TT3,FT3,TSH and their eGFR were measured.The risk facors for NAFLD in elderly type 2 DM patients with normal thyroid function were analyzed by multivariate logistic regression analysis.Results The incidence of NAFLD was 42.6%in the 519 elderly type 2 DM patients included in this study and was 66.1%,42.7%,33.3%respectively in 60-69,70-79,≥80 years old type 2 DM patients(P<0.05).The age was significantly younger and the serum direct bilirubin level was significantly lower while the BMI,serum levels of total protein,albumin,UA,HbA1 c,TC,TG,LDL-C,FT3,TT3,TSH and the eGFR were significantly higher in NAFLD group than in NAFLD-free group(P<0.05,P<0.01).Multivariate logistic regression analysis showed that age,BMI,and serum TG and TSH levels were the independent risk factors for NAFLD in elderly type 2 DM patients(OR=0.945,95%CI:0.917-0.973,P=0.000;OR=1.150,95%CI:1.057-1.251,P=0.001;OR=2.615,95%CI:1.767-3.868,P=0.000;OR=1.428,95%CI:1.016-2.006,P=0.040).Conclusion Serum TSH level is independently associated with NAFLD in elderly type 2 DM patients with normal thyroid function.
作者
魏雅楠
邓利华
刘杰
王晶桐
Wei Yanan;Deng Lihua;Liu Jie;Wang Jingtong(Department of Geriatrics,Peking University People’s Hospital,Beijing 100044,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2020年第8期836-839,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
作者简介
通信作者:王晶桐,Email:wangjingtongl1@163.com。
