摘要
目的探讨甲状腺激素敏感性指标与高尿酸血症的关系及性别差异。方法选取2024年1-12月于佛山市第一人民医院健康管理中心体检的甲状腺功能正常者2922例作为研究对象。研究对象根据高尿酸血症的诊断标准分为非高尿酸血症者2077例(正常组)、高尿酸血症者845例(高尿酸血症组)。比较正常组和高尿酸血症组临床资料。Spearman相关性分析甲状腺功能和甲状腺激素敏感性指标与高尿酸血症的相关性。采用Logistic回归分析甲状腺激素敏感性指标对高尿酸血症发生的影响,并对不同性别高尿酸血症患者甲状腺激素敏感性指标进行比较。结果高尿酸血症组男性占比、收缩压、舒张压、体重指数、肌酐、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、糖化血红蛋白、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、FT3甲状腺反馈分位数指数(TFQI_(FT3))、FT4甲状腺反馈分位数指数(TFQI_(FT4))、促甲状腺激素甲状腺素抵抗指数(TT4RI)、促甲状腺激素指数(TSHI)、FT3/FT4比值均高于正常组,而女性占比、年龄、高密度脂蛋白胆固醇、红细胞沉降率均低于正常组,差异有统计学意义(P<0.05)。Spearman相关性分析结果显示,血尿酸水平与FT3、FT4、TFQI_(FT3)、TFQI_(FT4)、TT4RI、TSHI、FT3/FT4比值呈正相关(均P<0.05),与促甲状腺激素无相关性(P>0.05)。Logistic回归分析结果显示:男性高尿酸血症患者中,TFQI_(FT3)、TFQI_(FT4)、TT4RI及TSHI是其高尿酸血症发生的影响因素(P<0.05);女性高尿酸血症患者中,仅TFQI_(FT3)是其高尿酸血症发生的影响因素(P<0.05)。男性高尿酸血症患者TFQI_(FT3)、TFQI_(FT4)、FT3/FT4比值显著高于女性高尿酸血症患者,差异有统计学意义(P<0.05)。结论甲状腺激素敏感性指标与高尿酸血症相关,TFQI_(FT3)可作为预测高尿酸血症的有效指标,TFQI_(FT4)与高尿酸血症的关联性在不同性别中可能存在差异。
Objective To explore the relationship between thyroid hormone sensitivity indicators and hyperuricemia,as well as gender differences.Methods A total of 2922 individuals with normal thyroid function who underwent physical examinations at the health management center of the First People's Hospital of Foshan from January to December 2024 were selected as the research subjects.The research subjects were divided into 2077 cases of non-hyperuricemia(normal group)and 845 cases of hyperuricemia(hyperuricemia group)according to the diagnostic criteria of hyperuricemia.Clinical data were compared between the normal group and the hyperuricemia group.Spearman correlation analysis was used to analyze the correlation between thyroid function and thyroid hormone sensitivity indicators and hyperuricemia.Logistic regression was used to an alyze the influence of thyroid hormone sensitivity indicators on the occurrence of hyperuricemia,and the thy-roid hormone sensitivity indicators of patients with hyperuricemia of different genders were compared.Results In the hyperuricemia group,the male proportion,systolic blood pressure,diastolic blood pressure,body mass index,creatinine,total cholesterol,triglycerides,low-density lipoprotein cholesterol,glycated hemoglobin,free triiodothyronine(FT3),free thyroxine(FT4),FT3 thyroid feedback quantile index(TFQI_(FT3)),FT4 thyroid feedback quantile index(TFQI_(FT4)),thyroid stimulating hormone resistance index(TT4RI),thyroid stimula-ting hormone index(TSHI),and FT3/FT4 ratio were all elevated compared to those in the normal group,while the female proportion,age,high-density lipoprotein cholesterol,and erythrocyte sedimentation rate were all lower than those in the normal group,and the differences were statistically significant(P<0.05).The results of Spearman correlation analysis showed that serum uric acid levels were positively correlated with FT3,FT4,TFQI_(FT3),TFQI_(FT4),TT4RI,TSHI,and the ratio of FT3/FT4(all P<0.05),but not correlated with thyroid stimulating hormone(P>0.05).The results of Logistic regression analysis showed that among male patients with hyperuricemia,TFQI_(FT3),TFQI_(FT4),TT4RI and TSHI were the influencing factors for the occurrence of hyperuricemia(P<0.05).Among female patients with hyperuricemia,only TFQI_(FT3) was an influencing factor for the occurrence of hyperuricemia(P<0.05).The ratios of TFQI_(FT3),TFQI_(FT4),and FT3/FT4 ratio in male patients with hyperuricemia were significantly higher than those in female patients,and the differences were statistically significant(P<0.05).Conclusion Thyroid hormone sensitivity indicators are associated with hyperuricemia.TFQI_(FT3) can be used as an effective indicator for predicting hyperuricemia.The association between TFQI_(FT4) and hyperuricemia may vary between different genders.
作者
梁权辉
曾惠娴
何玉怡
潘练华
陈活强
LIANG Quanhui;ZENG Huixian;HE Yuyi;PAN Lianhua;CHEN Huoqiang(Department of Clinical Laboratory,the First People's Hospital of Foshan,Foshan,Guangdong 528000,China;Department of Endocrinology,the Second People's Hospital of Foshan,Affiliated Foshan Hospital of Guangdong Pharmaceutical University,Foshan,Guangdong 528000,China)
出处
《国际检验医学杂志》
2025年第24期2965-2969,共5页
International Journal of Laboratory Medicine
基金
佛山市卫生健康局医学科研课题(20230224)
佛山市“十四五”医学高水平重点专科建设项目(FSGSP145007)
佛山市第二人民医院创新研究基金项目(2024D07)。
