天津医药

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甲状腺激素对2型糖尿病患者颈动脉粥样硬化的影响

陈光敏1,张雅静1,赵伟2,张琳3,李文静1,张宏2   

  1. 1. 天津医科大学代谢病医院
    2. 天津医大代谢病医院
    3. 天津医科大学代谢病医院9楼
  • 收稿日期:2012-02-15 修回日期:2012-07-31 出版日期:2012-12-15 发布日期:2012-12-15
  • 通讯作者: 陈光敏

The Effect of Thyroid Hormones on Carotid Arteries Atherosclerosis in Type 2 Diabetic Subjects

  • Received:2012-02-15 Revised:2012-07-31 Published:2012-12-15 Online:2012-12-15
  • Contact: Guang-Min CHEN

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摘要： 摘要 目的：探讨正常值范围内甲状腺激素对2型糖尿病患者（T2DM）颈部动脉粥样硬化的影响。方法：以颈动脉多普勒超声检查所见狭窄程度对2010年1月至2010年12月住我院治疗的248例T2DM患者进行分组，对照组92例、轻度狭窄组（狭窄<30%）32例、中度狭窄组（30%≤狭窄<70%）93例、重度狭窄组（≥70%组）31例，回顾性分析2型糖尿病患者的颈部动脉超声检查结果与血清甲状腺激素水平及其他影响因素的关系。结果：重度狭窄组的游离三碘甲状腺原氨酸（FT3）、高密度脂蛋白胆固醇（HDL-C)均低于轻、中度狭窄组与对照组，差异有统计学意义（P<0.01或P<0.05）；重度狭窄组的三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇（LDL-C）、收缩压（SBP）均高于轻、中度狭窄组与对照组，差异有统计学意义（P<0.01或P<0.05）；轻、中、重度狭窄组FT3、HDL-C均低于对照组，差异有统计学意义（P<0.01或P<0.05）；中、重度狭窄组的病程、体质指数（BMI）、糖化血红蛋白（HbA1c）均高于对照组，差异有统计学意义（P<0.01或P<0.05）。颈动脉狭窄与FT3、HDL-C呈负相关（P<0.01），与BMI、HbA1c、病程、年龄、LDL-C、TG、TC、SBP、舒张压（DBP）呈正相关（P<0.05）；多因素Logistic回归分析结果显示FT3、HDL-C升高是颈动脉狭窄的保护因素，年龄、SBP、TG升高是颈动脉狭窄的危险因素。结论：正常值范围内偏高的FT3可能对T2DM患者动脉粥样硬化具有保护作用。

关键词: 糖尿病, 2型颈动脉动脉粥样硬化甲状腺激素

Abstract: Abstract Objective: To explor The effect of thyroid hormone on carotid arteries atherosclerosis in type 2 diabetic subjects with euthyroidism。Methods:248 T2DM patients who hospitalized in Tianjin Metabolic Disease Hospital between January to December,2010 were divided into four groups : 92 patients (control group) without stenosis,32 patients (mild stenosis group) with stenosis<30%,93 patients (moderate stenosis group) with 30%≤stenosis<70%,31 patients (severe stenosis group) with stenosis>70% by color Doppler ultrasound of carotid arteries . The serum thyroid hormone were analysed in subjects of groups.Results: There were significant differences in the values of serum triiodothyronine(FT3)、high-density lipoprotein（HDL-C）between severe stenosis group and other three groups（P<0.01 or P<0.05）；Spearman’s correlation analysis demonstrated that carotid arteries atherosclerosis was negatively correlated with FT3、HDL-C（P<0.01）and positively correlated with body mass index(BMI)、glycosylated HbA1c、course of disease、age、low-density lipoprotein（LDL-C）、trglyceride（TG）、total cholesterol(TC)、systolic blood pressure（SBP）、diastolic blood pressure.Logistic regression analysis showed that age、SBP、TG heightening are independent risk factors affected the severity of carotid arteries atherosclerosis，FT3、HDL-C heightening are independent protective factors affected the severity of carotid arteries atherosclerosis.Conclusion: FT3 within a normal level might be a protect factor for atherosclerosis in patients with T2DM.

Key words: Diabetes Mellitus, Type 2 DiabeticCarotid ArteriesAtherosclerosisThyroid Hormones