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
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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。
Abstract:
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.
