甲状腺功能正常人群中多种甲状腺参数与糖尿病风险的关系
目的:探讨甲状腺功能正常人群的甲状腺功能指标及甲状腺激素敏感指数与糖尿病风险的关系。方法:该研究为横断面研究。纳入2017年1月至2018年12月于中国医科大学附属第一医院体检中心进行甲状腺功能检测，显示甲状腺功能正常且基线数据完整的4 586名研究对象。收集研究对象的一般临床资料，包括促甲状腺激素（TSH）、游离三碘甲腺原氨酸（FT 3）、游离甲状腺素（FT 4）、血脂、空腹血糖（FPG）、糖化血红蛋白（HbA 1c）等。计算分别反映甲状腺激素中枢和外周敏感性的甲状腺反馈分位数指数（TFQI）和FT 3/FT 4。采用Spearman相关性分析探究甲状腺参数与FPG和HbA 1c的相关性，进...
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| Published in | 中华糖尿病杂志 Vol. 13; no. 9; pp. 879 - 884 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | Chinese |
| Published |
中国医科大学附属第一医院内分泌科 内分泌研究所 辽宁省内分泌疾病重点实验室，沈阳 110001%中国医科大学附属第一医院体检中心，沈阳 110001
27.09.2021
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 1674-5809 |
| DOI | 10.3760/cma.j.cn115791-20210204-00074 |
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| Abstract | 目的:探讨甲状腺功能正常人群的甲状腺功能指标及甲状腺激素敏感指数与糖尿病风险的关系。方法:该研究为横断面研究。纳入2017年1月至2018年12月于中国医科大学附属第一医院体检中心进行甲状腺功能检测，显示甲状腺功能正常且基线数据完整的4 586名研究对象。收集研究对象的一般临床资料，包括促甲状腺激素（TSH）、游离三碘甲腺原氨酸（FT
3）、游离甲状腺素（FT
4）、血脂、空腹血糖（FPG）、糖化血红蛋白（HbA
1c）等。计算分别反映甲状腺激素中枢和外周敏感性的甲状腺反馈分位数指数（TFQI）和FT
3/FT
4。采用Spearman相关性分析探究甲状腺参数与FPG和HbA
1c的相关性，进一步排除混杂因素的干扰，采用logistic回归模型分析甲状腺参数与糖尿病风险的关联。
结果:4 586名研究对象中，糖尿病组患者546例，患病率为11.9%（546/4 586）。FPG水平与FT
3（
r=0.049，
P=0.001）、FT
4（
r=0.041，
P=0.005）和TFQI（
r=0.041，
P=0.006）呈正相关，与TSH（
r=-0.058，
P<0.01）呈负相关；HbA
1c水平与FT
4（
r=-0.032，
P=0.032）、TSH（
r=-0.032，
P=0.029）和TFQI（
r=-0.032，
P=0.032）呈负相关。但校正年龄、性别和体重指数等混杂因素的多因素logistic回归分析表明，糖尿病风险仅与FT
3（OR=0.57，95%CI为0.46~0.70）和FT
3/FT
4（OR=0.78，95%CI为0.70~0.86）水平呈负相关，而与TSH、FT
4和TFQI水平无显著关联。
结论:在甲状腺功能正常的人群中，FT
3和反映外周甲状腺激素敏感性的FT
3/FT
4水平增加与糖尿病风险降低有关。 |
|---|---|
| AbstractList | 目的:探讨甲状腺功能正常人群的甲状腺功能指标及甲状腺激素敏感指数与糖尿病风险的关系。方法:该研究为横断面研究。纳入2017年1月至2018年12月于中国医科大学附属第一医院体检中心进行甲状腺功能检测，显示甲状腺功能正常且基线数据完整的4 586名研究对象。收集研究对象的一般临床资料，包括促甲状腺激素（TSH）、游离三碘甲腺原氨酸（FT
3）、游离甲状腺素（FT
4）、血脂、空腹血糖（FPG）、糖化血红蛋白（HbA
1c）等。计算分别反映甲状腺激素中枢和外周敏感性的甲状腺反馈分位数指数（TFQI）和FT
3/FT
4。采用Spearman相关性分析探究甲状腺参数与FPG和HbA
1c的相关性，进一步排除混杂因素的干扰，采用logistic回归模型分析甲状腺参数与糖尿病风险的关联。
结果:4 586名研究对象中，糖尿病组患者546例，患病率为11.9%（546/4 586）。FPG水平与FT
3（
r=0.049，
P=0.001）、FT
4（
r=0.041，
P=0.005）和TFQI（
r=0.041，
P=0.006）呈正相关，与TSH（
r=-0.058，
P<0.01）呈负相关；HbA
1c水平与FT
4（
r=-0.032，
P=0.032）、TSH（
r=-0.032，
P=0.029）和TFQI（
r=-0.032，
P=0.032）呈负相关。但校正年龄、性别和体重指数等混杂因素的多因素logistic回归分析表明，糖尿病风险仅与FT
3（OR=0.57，95%CI为0.46~0.70）和FT
3/FT
4（OR=0.78，95%CI为0.70~0.86）水平呈负相关，而与TSH、FT
4和TFQI水平无显著关联。
结论:在甲状腺功能正常的人群中，FT
3和反映外周甲状腺激素敏感性的FT
3/FT
4水平增加与糖尿病风险降低有关。 |
| Abstract_FL | Objective:To evaluate the association between the indicators of thyroid function, sensitivity to thyroid hormones and risk of diabetes in euthyroid population.Methods:In this cross-sectional study, 4 586 euthyroid subjects who had complete baseline data from the health check-up programs in the First Hospital of China Medical University between January 2017 and December 2018 were enrolled. Relevant clinical data including thyrotropin (TSH), free triiodothyronine (FT
3), free thyroxine (FT
4), blood lipid profiles, fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA
1c) were collected. Thyroid feedback quantile based index (TFQI) and FT
3/FT
4 ratio, which reflected the central and peripheral sensitivity to thyroid hormones respectively, were calculated. Spearman correlation analysis between thyroid parameters and indicators of glucose metabolism was performed. To further exclude the interference of cofounding factors, logistic regression analysis was used to evaluate the association between thyroid parameters and the risk of diabetes.
Results:Among 4 586 subjects enrolled in this study, 546 (11.9%) were diagnosed with diabetes. The level of fasting blood glucose was positively associated with the level of FT
3 (
r=0.049,
P=0.001), FT
4 (
r=0.041,
P=0.005) and TFQI (
r=0.041,
P=0.006), while negatively associated with the level of TSH (
r=-0.058, P<0.01). HbA
1c was negatively associated with FT
4 (
r=-0.032,
P=0.032), TSH (
r=-0.032,
P=0.029) and TFQI (
r=-0.032,
P=0.032). However, multivariate logistic regression analysis adjusting for confounding factors such as age, sex and BMI, showed that the risk of diabetes was negatively associated with the level of FT
3 (OR=0.57, 95%CI 0.46 to 0.70) and FT
3/FT
4 (OR=0.78, 95%CI 0.70 to 0.86), while was not significantly associated with the level of TSH, FT
4 and TFQI.
Conclusion:Increased levels of FT
3 and FT
3/FT
4 (indicators of peripheral sensitivity to thyroid hormones) were associated with lower risk of diabetes in euthyroid population. |
| Author | 王紫霄 关海霞 刘鹤 李佳蓉 付金蓉 杨思珏 王巍 |
| AuthorAffiliation | 中国医科大学附属第一医院内分泌科 内分泌研究所 辽宁省内分泌疾病重点实验室，沈阳 110001%中国医科大学附属第一医院体检中心，沈阳 110001 |
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| Author_FL | Yang Sijue Wang Zixiao Liu He Fu Jinrong Wang Wei Li Jiarong Guan Haixia |
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| DOI | 10.3760/cma.j.cn115791-20210204-00074 |
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| Keywords | 甲状腺激素敏感性 Blood glucose 甲状腺功能试验 Glycohemoglobin 血糖 Diabetes mellitus Sensitivity to thyroid hormones Thyroid function tests 糖尿病 糖化血红蛋白 |
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| PublicationTitle | 中华糖尿病杂志 |
| PublicationTitle_FL | Chinese Journal of Diabetes Mellitus |
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| Publisher | 中国医科大学附属第一医院内分泌科 内分泌研究所 辽宁省内分泌疾病重点实验室，沈阳 110001%中国医科大学附属第一医院体检中心，沈阳 110001 |
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