文章摘要
方 达,刘 颖,马向华.促甲状腺激素正常的新诊断2型糖尿病患者BMI对糖、脂代谢,肝肾、甲状腺功能的影响[J].南京医科大学学报,2019,(5):700~703
促甲状腺激素正常的新诊断2型糖尿病患者BMI对糖、脂代谢,肝肾、甲状腺功能的影响
Effects of body mass index on glucose and lipid metabolism,hepatic,renal and thyroid function in newly diagnosed type 2 diabetes mellitus patients with normal serum TSH
投稿时间:2019-01-13  
DOI:10.7655/NYDXBNS20190514
中文关键词: 2 型糖尿病  肥胖  甲状腺激素
英文关键词: type 2 diabetes mellitus  obesity  thyroid hormones
基金项目:江苏省中医药局科技项目(YB2015164)
作者单位
方 达 南京医科大学第一附属医院内分泌科江苏 南京 210029 
刘 颖 南京医科大学第一附属医院内分泌科江苏 南京 210029 
马向华 南京医科大学第一附属医院内分泌科营养科江苏 南京 210029 
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中文摘要:
      目的:探讨促甲状腺激素正常的新诊断2型糖尿病患者体重指数(body mass index,BMI)与糖、脂代谢,肝肾、甲状腺功能的关系。方法:收集2016 年1 月—2017 年12 月本院内分泌门诊156例促甲状腺激素正常的新诊断2型糖尿病患者的临床资料,按照BMI水平分为肥胖组(BMI≥28.0 kg/m2)、超重组(24.0 kg/m2≤BMI<28.0 kg/m2)、正常组(BMI<24.0 kg/m2)。分析3组患者各项代谢指标的差异以及BMI与各代谢指标的关系。结果:3组患者的丙氨酸氨基转移酶(ALT)、γ?谷氨酰转肽酶(γ?GT)、总胆固醇(TC)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA?IR)、空腹 C 肽(CP)、血浆促甲状腺激素(TSH)差异有统计学意义(P < 0.05)。相关分析表明,在校正性别、年龄、糖化血红蛋白(HbA1c)后,随着BMI的升高,ALT、γ?GT 、FINS、HOMA?IR、CP、TSH也升高,呈正相关(r=0.22、0.19、0.36、0.38、0.27、0.22,P < 0.05)。结论:TSH正常的新诊断2型糖尿病患者的BMI水平对机体相关代谢指标如ALT、γ?GT 、TC、FINS、HOMA?IR、CP、TSH均有影响,且BMI水平与ALT、γ?GT 、FINS、HOMA?IR、CP、TSH水平呈正相关。可将TSH水平作为评估新诊断的2型糖尿病患者,特别是肥胖的2型糖尿病人群代谢紊乱的参考指标和并发症随访观察的指标,及时给予适当干预。
英文摘要:
      Objective:To explore the relationship between body mass index(BMI)and different metabolic variables(glucose and lipid metabolism,hepatic,renal and thyroid function)in newly diagnosed type 2 diabetes mellitus patients with normal serum TSH. Methods:We retrospectively collected clinical data from 156 newly diagnosed type 2 diabetes mellitus patients with normal serum TSH in our center,including gender,age,BMI,alanine aminotransferase(ALT),γ?glutamyltransferase(γ?GT),blood urea nitrogen(BUN),creatinine(Cr),uric acid(UA),fasting plasma glucose(FPG),fasting C?peptide(CP),fasting insulin(FINS),glycosylated hemoglobin A1c(HbA1c),insulin resistance(HOMA?IR),triglyceride(TG),total cholesterol(TC),low?density lipoprotein cholesterol(LDL?C),high?density lipoprotein cholesterol(HDL?C),free triiodothyronine(FT3),free thyroxin(FT4),thyroid stimulating hormone(TSH). All the patients were divided into the obesity group(BMI ≥28.0 kg/m2),the overweight group(24.0 kg/m2≤BMI<28.0 kg/m2)and the normal weight group(BMI<24.0 kg/m2)according to BMI. The differences of metabolic variables among three groups and the correlation between BMI and different metabolic variables were analyzed. Results:Levels of ALT,γ?GT,TC,FINS,HOMA?IR,CP and TSH among groups were significantly different(P < 0.05). After adjustment for gender,age and HBA1c,levels of ALT,γ?GT,FINS,HOMA?IR,CP and TSH increased with the increase of BMI(r=0.22,0.19,0.36,0.38,0.27,0.22,P < 0.05). Conclusion:BMI could significantly affect ALT,γ?GT,TC,FINS,HOMA?IR,CP and TSH in newly diagnosed type 2 diabetes mellitus patients with normal serum TSH. Besides,ALT,γ?GT,FINS,HOMA?IR,CP and TSH were positively correlated with BMI. TSH level could serve as an index in evaluating metabolic disorder and follow?up in newly diagnosed type 2 diabetes mellitus,especially with obesity.
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