CAJ | 학술논문

目的研究原发性甲状腺功能减退症患者糖代谢异常的临床特点及危险因素.方法收集2008年2月至2010年7月中国医科大学附属第一医院内分泌科病房收治的26例已行口服葡萄糖耐量试验(OGTT)的原发性甲状腺功能减退症患者26例,分为先被诊断甲状腺功能减退症后发现高血糖组(A组,n=14)、先发现高血糖后被诊断甲状腺功能减退症组(B组,n=6)和糖代谢正常组(C组,n=6),记录年龄、病程,测定空腹血糖、OGTT 2 h血糖、甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平.采用Kruskal-Wallis检验、Fisher精确概率检验进行数据统计.结果 26例原发性甲状腺功能减退症患者均未出现低血糖.A组14例患者OGTT2 h血糖明显高于C组[(9.3±0.3)vs(6.4±0.2) mmol/L,t=-7.390,P＜0.01],且均为糖耐量减低,空腹血糖受损6例；B组糖尿病5例,糖耐量减低1例.C组、A组、B组患者年龄和体质指数呈逐渐增高趋势.多因素logistic回归分析显示,体质指数[比值比(OR) =1.74,95％可信区间(CI) 1.01 ～2.98,P＜0.05]和年龄(OR=1.18,95％ CI 1.02～1.37,P＜0.05)是OGTT2 h血糖升高的独立危险因素.结论原发性甲状腺功能减退症患者发生高血糖并不少见,血糖升高以负荷后为主,且与体质指数和年龄有关.
목적 연구원발성갑상선공능감퇴증환자당대사이상적림상특점급위험인소.방법 수집2008년2월지2010년7월중국의과대학부속제일의원내분비과병방수치적26례이행구복포도당내량시험(OGTT)적원발성갑상선공능감퇴증환자26례,분위선피진단갑상선공능감퇴증후발현고혈당조(A조,n=14)、선발현고혈당후피진단갑상선공능감퇴증조(B조,n=6)화당대사정상조(C조,n=6),기록년령、병정,측정공복혈당、OGTT 2 h혈당、감유삼지、총담고순、고밀도지단백담고순、저밀도지단백담고순수평.채용Kruskal-Wallis검험、Fisher정학개솔검험진행수거통계.결과 26례원발성갑상선공능감퇴증환자균미출현저혈당.A조14례환자OGTT2 h혈당명현고우C조[(9.3±0.3)vs(6.4±0.2) mmol/L,t=-7.390,P＜0.01],차균위당내량감저,공복혈당수손6례；B조당뇨병5례,당내량감저1례.C조、A조、B조환자년령화체질지수정축점증고추세.다인소logistic회귀분석현시,체질지수[비치비(OR) =1.74,95％가신구간(CI) 1.01 ～2.98,P＜0.05]화년령(OR=1.18,95％ CI 1.02～1.37,P＜0.05)시OGTT2 h혈당승고적독립위험인소.결론 원발성갑상선공능감퇴증환자발생고혈당병불소견,혈당승고이부하후위주,차여체질지수화년령유관.
Objective To analyze the clinical characters of abnormal glucose metabolism in hypothyroid patients and its potential risk factors. Methods Twenty-six primary hypothyroidism patients who were admitted to the Department of Endocrinology in the First Affiliated Hospital of China Medical University from February 2008 to July 2010 and underwent oral glucose tolerance test (OGTT) were enrolled in this retrospective study.According to their medical records and blood glucose levels,the patients were assigned to three groups:group A,hyperglycemia occurred later than hypothyroidism (n =14); group B,hyperglycemia was found earlier than hypothyroidism ( n =6) ; and group C,glucose metabolism was normal (n =6).Clinical data such as age,hypothyroid duration and blood glucose level were compared between the groups.Kruskal-Wallis or Fisher test was used for data analysis.Results None of the patients developed hypoglycemia.All the patients in group A showed impaired glucose tolerance ( IGT),while only 42.9％ (6/14) had impaired fasting glucose (IFG).About 83.3％ (5/6) patients in group B had diabetes mellitus,while 16.7％ (1/6) only had IGT.OGTT 2-h blood glucose level in group A was obviously higher than that in group C ( ( 9.3 ± 0.3 ) vs (6.4 ± 0.2 ) mmol/L,t =- 7.390,P ＜ 0.01 ).There was an increasing trend in age and body mass index (BMI) in group C,A and B.BM1 and age were independent risk factors of elevated OGTT 2-h plasma glucose.Conclusions Hyperglycemia was not rare in patients with primary hypothyroidism,and elevated post-load plasma glucose was the predominant pattern,which might be correlated with BMI and age.