摘要： 目的 探讨脂代谢异常人群亚临床甲状腺功能减退（SCH）的患病特点及危险因素。方法 对甘肃省内2 463例汉族成年居民进行调查，记录受试者一般资料、生化指标和甲状腺功能，χ²检验分析脂代谢异常人群SCH的患病情况，logistic回归分析脂代谢异常人群患SCH的危险因素。结果 共纳入调查对象2 463例（男1 299例，女1 164例），总人群中脂代谢异常503例，SCH患病538例。脂代谢异常人群中SCH患病率明显高于正常人群（26.64% vs 20.16%，P=0.004），SCH组年龄、体质量指数（BMI）、收缩压（SP）、舒张压（DP）、空腹血糖（FPG）、口服葡萄糖耐量试验（OGTT）负荷后2 h血糖（2 h PG）、总胆固醇（TG）、甘油三酯（TC）、低密度脂蛋白胆固醇（LDL-C）、谷草转氨酶（AST）、血磷（P）、糖化血红蛋白（HbA1c）、抗甲状腺过氧化物酶抗体（TPOAb）和抗甲状腺球蛋白抗体（TgAb）均高于正常组，尿酸（UA）低于正常组（均P < 0.05）。TC和LDL-C水平正常、升高与异常3组间SCH患病率差异有统计学意义。Logistic回归分析显示，增龄、高SP、高FPG、高2 h PG为SCH的危险因素，男性为保护因素。结论 脂代谢异常与SCH的发生密切相关，患病情况在女性中更为突出，应重视其防治。

脂代谢异常人群亚临床甲状腺功能减退患病率及相关因素分析

常星宇^1,2, 傅松波^1,2, 汤旭磊^1,2, 刘靖芳^1,2, 赵楠^1,2, 井高静^1,2, 滕卫平³, 单忠艳³

1. 兰州大学第一医院内分泌科, 兰州 730000;
2. 甘肃省内分泌疾病临床医学研究中心, 兰州 730000;
3. 中国医科大学附属第一医院内分泌与代谢病科, 内分泌研究所, 辽宁省内分泌疾病重点实验室, 沈阳 110001

收稿日期:2020-11-20出版日期:2021-11-30发布日期:2021-11-04
通讯作者:傅松波E-mail:2358852042@qq.com
作者简介:常星宇(2000-),男,本科在读.
基金资助:2020年度中央引导地方科技发展专项（甘肃地区多发病防治能力提升创新平台）；国家卫健委公益性行业科研专项（201402005）；兰州市城关区科技计划项目（2013-7-4）；兰州市科技发展指导性计划项目（2019-ZD-38）；兰州大学2021年大学生创新创业计划（20210060122）


关键词: 亚临床甲状腺功能减退, 脂代谢, 影响因素
Abstract: Objective To investigate the characteristics and risk factors of subclinical hypothyroidism (SCH) in patients with abnormal lipid metabolism. Methods a total of 2 463 Han adults in Gansu province were investigated. Their general information, biochemical parameters, and thyroid function were recorded. The χ² test was used to analyze the prevalence of SCH in patients with abnormal lipid metabolism, while logistic regression was used to analyze the risk factors of SCH in patients with abnormal lipid metabolism. Results A total of 2 463 subjects (1 299 men, 1 164 women) were included in the study; of them, 503 had abnormal lipid metabolism and 538 had SCH disease. The prevalence of SCH in the abnormal lipid metabolism group was significantly higher than that in the normal population (26.64% vs 20.16%, P=0.004). Mean SCH group age, body mass index, systolic blood pressure (SP), diastolic blood pressure, fasting plasma glucose (FPG), blood glucose 2 hours after an oral glucose tolerance test (2-h PG), triglyceride, total cholesterol (TC), low-density lipoprotein (LDL-C), aspartate aminotransferase, serum phosphorus, hemoglobin A1c, thyroid peroxidase antibody, and thyroglobulin antibody levels were higher than those in the normal group, while uric acid level was lower than that of the normal group (all P < 0.05). The prevalence of SCH in normal, elevated and the abnormal TC and LDL-C groups was statistically significant. A logistic regression analysis showed that aging and high SP, high FPG, high 2-h PG levels were risk factors, whereas male sex was a protective factor. Conclusion Abnormal lipid metabolism is closely related to the occurrence of SCH, which is more prominent in women. Attention should be paid to the prevention and treatment of SCH.
Key words: subclinical hypothyroidism, lipid metabolism, influencing factors
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