摘要
目的探讨血清甲状腺激素(thyroid hormone,TH)、C肽、糖化血红蛋白A1c(glycated hemoglobin A1c,HbA1c)在2型糖尿病(diabetes mellitus type 2,T2DM)中的表达及临床意义。方法选取2021年3月至2022年7月景德镇市第二人民医院收治的50例T2DM患者作为观察组,选取同期50名本院健康体检者作为对照组。所有受检者均进行血清学检测。比较两组、不同年龄、不同HbA1c水平患者TH指标[四碘甲状腺原氨酸(thyroxine,T_(4))、三碘甲状腺原氨酸(triiodothyronine,T_(3))、游离三碘甲状腺原氨酸(free triiodothyronine,FT_(3))、游离甲状腺素(free thyroxine,FT_(4))、促甲状腺激素(thyroid-stimulating hormone,TSH)];比较两组HbA1c与血清C肽水平,分析观察组HbA1c水平与TH指标的相关性,分析C肽、HbA1c、TH指标单独及联合诊断对T2DM的诊断效能。结果观察组T_(4)、FT_(4)水平均高于对照组,T_(3)、FT_(3)水平均低于对照组,差异有统计学意义(P<0.05);两组TSH水平比较差异无统计学意义。观察组HbA1c水平高于对照组,空腹及餐后2 h血清C肽水平均低于对照组,差异有统计学意义(P<0.05)。HbA1c水平<7%患者的T_(3)、FT_(3)水平均高于HbA1c水平7%~10%、>10%患者,而T_(4)、FT_(4)水平均低于HbA1c水平7%~10%、>10%患者,差异有统计学意义(P<0.05);不同HbA1c水平患者的TSH水平比较差异无统计学意义。年龄>55岁患者的T_(3)、FT_(3)水平均低于≤55岁患者,差异有统计学意义(P<0.05),而不同年龄患者T_(4)、FT_(4)、TSH水平比较差异无统计学意义。Pearson相关性分析显示,HbA1c与T_(3)、FT_(3)呈负相关(r<0,P<0.05),与T_(4)呈正相关(r>0,P<0.05)。受试者工作特征曲线分析显示,TH指标、C肽、HbA1c联合诊断T2DM的曲线下面积为0.987,灵敏度为100.00%。结论T2DM患者TH指标、血清C肽与HbA1c表达水平存在明显差异,HbA1c和TH指标具有相关性,TH指标、C肽、HbA1c联合诊断对T2DM的诊断效能较高,值得临床推广应用。
Objective To investigate the expression and clinical significance of serum thyroid hormone(TH),C-peptide and glycosylated hemoglobin A1c(HbA1c)in type 2 diabetes mellitus(T2DM).Methods 50 T2DM patients admitted to Jingdezhen Second People's Hospital from March 2021 to July 2022 were selected as the observation group,and 50 healthy individuals who underwent physical examinations at our hospital during the same period were selected as the control group.All subjects underwent serological testing.The TH indicators(thyroxine[T_(4)],triiodothyronine[T_(3)],free triiodothyronine[FT_(3)],free thyroxine[FT_(4)],thyroid stimulating hormone[TSH])was compared between the two groups,patients with different ages and different HbA1c levels;and the HbA1c and serum C-peptide levels were compared between the two groups,the correlation between HbA1c levels and TH indicators in the observation group was analyzed,the diagnostic efficacy of C-peptide,HbA1c and TH indicators alone and combination diagnosis for T2DM diagnosis was analyzed.Results The levels of T_(4) and FT_(4) in the observation group were higher than those in the control group,while the levels of T_(3) and FT_(3) were lower than those in the control group,the differences were statistically significant(P<0.05);there was no statistically significant difference in TSH levels between the two groups.The HbA1c level in the observation group was higher than that in the control group,and the serum C-peptide levels fasting and 2 h after meals were lower than those in the control group,the differences were statistically significant(P<0.05).The T_(3) and FT_(3) levels of patients with HbA1c level<7%were higher than those of patients with HbA1c level 7%~10%and>10%,while the T4 and FT4 levels were lower than those of patients with HbA1c level 7%~10%and>10%,the differences were statistically significant(P<0.05);there were no difference in TSH levels of patients with different HbA1c levels.The T_(3) and FT_(3) levels of patients with age>55 years old were lower than those of patients with≤55 years old,the differences were statistically significant(P<0.05),while there were no different significant in T_(4),FT_(4) and TSH levels between patients of different age.Pearson correlation analysis showed that HbA1c was negatively correlated with T_(3) and FT_(3)(r<0,P<0.05),and positively correlated with T_(4)(r>0,P<0.05).Receiver characteristic curve analysis showed that the area under the cure of the combined diagnosis of TH indicators,C-peptide and HbA1c for T2DM was 0.987 and the sensitivity was 100.00%.Conclusion There are significant abnormal changes in TH indicators,serum C-peptide and HbA1c expression in T2DM patients,and HbA1c and TH indicators are correlated,combined diagnostic of TH indicators,C peptide and HbA1c has a high diagnostic value for T2DM,which is worthy of clinical promotion and application.
作者
曾海克
胡凯
张玲
黄水兰
ZENG Haike;HU Kai;ZHANG Ling;HUANG Shuilan(Jingdezhen Key Laboratory of Cell and Molecular Medicine,Jingdezhen Second People's Hospital,Jingdezhen,Jiangxi,333000,China)
出处
《当代医学》
2025年第4期35-39,共5页
Contemporary Medicine
关键词
2型糖尿病
血清C肽
血清甲状腺激素
糖化血红蛋白A1C
表达
Type 2 diabetes mellitus
Serum C peptide
Serum thyroid hormone
Glycosylated hemoglobin A1c
Expression
