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目的:探讨甲状腺机能亢进症(简称甲亢)合并2型糖尿病患者促甲状腺激素受体抗体(TRAB)阳性对其血糖、血脂代谢指标的影响。方法:新发T2DM合并甲亢患者30例,根据TRAB滴度分为抗体阳性组(A组:TRAB>1.5 IU/L)和抗体阴性组(B组:TRAB≤1.5 IU/L);单纯初发2型糖尿病患者30例作为对照组(C组)。检测3组患者体质指数(BMI)、血清甘油三脂(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、糖化血红蛋白(HbA1c)、空腹血糖(FBG)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)、促甲状腺激素(TSH)的值。统计学检验用单因素方差分析和秩和检验。结果:3组之间年龄、FBG和HDL没有显著性差异(P>0.05)。A组和B组的BMI、TG和TC都低于C组,差异有统计学意义(P<0.05),但A组和B组相比差异无统计学意义(P>0.05)。3组间LDL-C和HbA1c水平均有显著性差异(P<0.05)。结论:TRAB阳性的甲亢合并2型糖尿病患者的血糖和血脂水平低于TRAB阴性者。自身免疫异常对糖脂代谢有一定影响。
Objective: To investigate the effects of thyrotropin receptor antibody (TRAB) positive in patients with hyperthyroidism (T2DM) and type 2 diabetes on blood glucose and lipid metabolism. Thirty patients with newly diagnosed T2DM complicated with hyperthyroidism were divided into four groups according to TRAB titer: antibody positive group (group A: TRAB> 1.5 IU / L) and antibody negative group (group B: TRAB≤1.5 IU / L) Thirty patients with type 2 diabetes served as control group (group C). The body mass index (BMI), serum triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), HbA1c ), Fasting blood glucose (FBG), free thyroxine (FT4), free triiodothyronine (FT3) and thyrotropin (TSH). Statistical tests using one-way analysis of variance and rank sum test. Results: There was no significant difference in age, FBG and HDL between the three groups (P> 0.05). The BMI, TG and TC in group A and group B were lower than those in group C, the difference was statistically significant (P <0.05). However, there was no significant difference between group A and group B (P> 0.05). The levels of LDL-C and HbA1c in the three groups were significantly different (P <0.05). CONCLUSIONS: The blood glucose and blood lipids in patients with TRAB-positive hyperthyroidism and type 2 diabetes are lower than those with negative TRAB. Abnormal autoimmune glucose and lipid metabolism have a certain impact.