摘要
目的探究2型糖尿病(T2DM)伴亚临床甲状腺功能减退(SCH)患者中血清脂联素(APN)的表达及与患者并发冠心病(CHD)的关系。方法选取核工业四一七医院2018年1月-2020年1月收治的60例单纯T2DM患者,35例T2DM合并SCH患者,另选择同期体检的50名健康志愿者作为对照组,对比三组临床指标,并比较单纯T2DM患者与T2DM患者冠心病发病率及T2DM合并SCH患者发生CHD后不同冠状病变支数APN水平,Pearson检验分析APN与各临床指标的相关性。结果对照组、单纯T2DM组及T2DM合并SCH组年龄、性别及高密度脂蛋白胆固醇(HDL-C)、游离甲状腺激素(FT4)比较差异无统计学意义(P>0.05);对照组空腹血糖(FPG)、糖化血红蛋白(HbA1c)、体质指数(BMI)、腰臀比(WHR)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、促甲状腺激素(TSH)、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)、IMT、Hcy、游离三碘甲状腺原氨酸(FT3)、APN与单纯T2DM组及T2DM合并SCH组比较差异均有统计学意义(P<0.05)。单纯T2DM组患者CHD的并发率为23.3%(14/60),显著低于T2DM合并SCH的45.7%(16/35),差异有统计学意义(P<0.05)。T2DM合并SCH不同冠状病变支数患者比较显示,冠状病变支数越多,APN水平越低,差异有统计学意义(P<0.05)。APN与TSH、IMT、Hcy存在负相关性,与T2DM合并CHD患者冠状动脉病变支数同样存在负相关性(P<0.05),与FPG、HbA1c、BMI、WHR、LDL-C、HDL-C、TGAb、TPOAb、FT3、FT4无相关性(P>0.05)。结论血清APN不仅与T2DM患者发生SCH有关,还与T2DM合并SCH患者血糖、血脂水平异常及并发冠心病存在相关性。
Objective To investigate the expression of serum adiponectin(APN)in patients with type 2 diabetes(T2DM)combined with subclinical hypothyroidism(SCH)and its relationship with patients with coronary heart disease(CHD).Methods 60 patients with simple T2DM and 35 patients with T2DM combined with SCH were selected from Feb.2018 to Feb.2020 in Nuclear Industry 417 Hospital;another 50 healthy volunteers who were examined in our hospital during the same period were selected as the control group.The clinical indicators,the incidence of coronary heart disease and the APN levels of different coronary lesions in patients with T2DM and patients with T2DM and SCH were compared.The correlation between APN and various clinical indicators was analyzed by Pearson test.Results There was no significant difference in age,sex,high-density lipoprotein cholesterol(HDL-C)and free thyroid hormone(FT4)between the control group,T2DM group and T2DM combined with SCH group(P>0.05).Fasting blood glucose(FPG),glycosylated hemoglobin(HbA1 c),body mass index(BMI),waist to hip ratio(WHR),total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),thyroid-stimulating hormone(TSH),thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPOAb),IMT,Hcy,free triiodothyronine(FT3),APN in the control group and the pure T2DM group and T2DM combined SCH group were significantly different(P<0.05).In the T2DM group,the CHD concurrency rate was 23.3%(14/60),which was significantly lower than the T2DM combined SCH concurrency rate of 45.7%(16/35)(P<0.05).Comparison of patients with T2DM and SCH with different coronary lesion counts showed that the more coronary lesions,the lower the APN level(P<0.05).Pearson correlation analysis found that APN was negatively correlated with TSH,IMT,and Hcy,andwas also negatively correlated with the number of coronary artery lesions in patients with T2DM and CHD(P<0.05).FPG,Hb A1 c,BMI,WHR,LDL-C,HDL-C,TGAb,TPOAb,FT3 and FT4 had no correlation(P>0.05).Conclusion SerumAPN was not only related to the occurrence of SCH in T2DM patients,but also related to abnormal blood glucose and bloodlipid levels in patients with T2DM and SCH and concurrent coronary heart disease.
作者
李俊叶
杨世峰
曹高峰
LI Jun-ye;YANG Shi-feng;CAO Gao-feng(Department of Internal Medicine,Nuclear Industry 417 Hospital,Xi'an r Shaanxi 710600;Department of Nephrology,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi 710061,China)
出处
《热带医学杂志》
CAS
2021年第5期609-612,共4页
Journal of Tropical Medicine
基金
陕西省自然科学基础研究计划(2019JM-537)。
关键词
2型糖尿病
亚临床甲状腺功能减退
冠心病
脂联素
血脂
Type 2 diabetes
Subclinical hypothyroidism
Coronary heart disease
Adiponectin
Blood lipids
作者简介
李俊叶(1982-),女,本科,主治医师,研究方向:糖尿病肾病最新治疗及研究、难治性肾综临床治疗,E-mail:Ljyljy19821982@163.com。
