甲状腺功能亢进症患者血清胎球蛋白A水平与胰岛素抵抗相关性研究

doi:10.3969/j.issn.1673-8640.2019.10.008

摘要/Abstract

摘要： 目的探讨甲状腺功能亢进症（简称甲亢）患者血清胎球蛋白A水平与胰岛素抵抗（IR）的关系。方法选取采用卡比马唑治疗的甲亢患者60例,所有患者均治愈。以体检健康者60名作为正常对照组。收集所有对象的一般资料（年龄、性别、身高、体质量等）,检测甲亢组治疗前后及正常对照组胎球蛋白A、促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT₃）、游离甲状腺素（FT₄）、胰岛素、C反应蛋白（CRP）、血钙、血糖水平。采用Pearson相关分析评估胎球蛋白A与各项指标之间的相关性。结果甲亢组治疗前体质量指数（BMI）、TSH明显低于治疗后及正常对照组（P<0.05）,FT₃、FT₄、血钙、CRP、胰岛素抵抗指数（HOMA-IR）、胎球蛋白A明显高于治疗后及正常对照组（P<0.05）。甲亢组治疗后BMI、TSH、FT₃、FT₄、血钙、CRP、胎球蛋白A与正常对照组比较差异均无统计学意义（P>0.05）,而HOMA-IR明显高于正常对照组（P<0.05）。甲亢患者治疗前、后血清胎球蛋白A与FT₃、FT₄、CRP、HOMA-IR均呈正相关（P<0.05）,与TSH均呈负相关（P<0.05）,与BMI、血钙均无相关性（P>0.05）。结论甲亢患者血清胎球蛋白A水平升高,可能与IR有关。

关键词: 胎球蛋白A, 甲状腺功能亢进症, 胰岛素抵抗, 卡比马唑

Abstract: Objective To investigate the relationship between serum fetuin A level and insulin resistance（IR） in hyperthyroidism patients. Methods A total of 60 patients with hyperthyroidism treated with carbimazole were enrolled,and these patients were all cured. Totally,60 healthy subjects were enrolled as healthy control group. The general data of all subjects（age,sex,height,weight and so on） were collected. The levels of fetuin A,thyroid stimulating hormone（TSH）,free triiodothyronine（FT₃）,free thyroxine（FT₄）,insulin,C-reactive protein（CRP）,serum calcium and blood glucose were determined before and after treatment in hyperthyroidism group and healthy control group. Pearson correlation analysis was used to evaluate the correlation between fetuin A and various indicators. Results Body mass index（BMI） and TSH in hyperthyroidism group before treatment were lower than those after treatment and healthy control group（P<0.05）,and FT₃,FT₄,serum calcium,CRP,homeostasis model assessment for insulin resistance（HOMA-IR） and fetuin A were higher than those after treatment and healthy control group（P<0.05）. There was no statistical significance for BMI,TSH,FT₃,FT₄,serum calcium,CRP and fetuin A between hyperthyroidism after treatment and healthy control group（P>0.05）,but HOMA-IR was higher than that in healthy control group（P<0.05）. Before and after treatment,serum fetuin A was positively correlated with FT₃,FT₄,CRP and HOMA-IR（P<0.05）,and it was negatively correlated with TSH（P<0.05）,but there was no correlation with BMI and serum calcium（P>0.05）. Conclusions Elevated serum fetuin A level in hyperthyroidism patients may be related to IR.

Key words: Fetuin A, Hyperthyroidism, Insulin resistance, Carbimazole

中图分类号:

R446.1

王炜城, 杨琼. 甲状腺功能亢进症患者血清胎球蛋白A水平与胰岛素抵抗相关性研究[J]. 检验医学, 2019, 34(10): 901-904.

WANG Weicheng, YANG Qiong. Correlation between serum fetuin A level and insulin resistance in patients with hyperthyroidism[J]. Laboratory Medicine, 2019, 34(10): 901-904.

图/表 1

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组别	例数	BMI（kg/m²）	TSH（mIU/L）	FT₃（pmol/L）	FT₄（pmol/L）
甲亢组
治疗前	60	23.52±3.11^*	0.04±0.02^*	11.22±2.57^*	36.78±12.58^*
治疗后	60	25.02±3.05^#	1.68±0.57^#	3.33±0.24^#	11.42±2.33^#
正常对照组	60	25.03±3.15	1.72±0.64	3.34±0.28	11.40±2.31
组别	血钙（mmol/L）		CRP（mg/L）	HOMA-IR	胎球蛋白A（μg/L）
甲亢组
治疗前	2.61±0.24^*		1.80±0.32^*	3.44±1.15^*	305.26±37.85^*
治疗后	2.41±0.14^#		1.15±0.28^#	2.25±0.29^*#	125.22±20.51^#
正常对照组	2.40±0.19		1.17±0.37	2.14±0.27	120.57±22.59

组别	例数	BMI（kg/m²）	TSH（mIU/L）	FT₃（pmol/L）	FT₄（pmol/L）
甲亢组
治疗前	60	23.52±3.11^*	0.04±0.02^*	11.22±2.57^*	36.78±12.58^*
治疗后	60	25.02±3.05^#	1.68±0.57^#	3.33±0.24^#	11.42±2.33^#
正常对照组	60	25.03±3.15	1.72±0.64	3.34±0.28	11.40±2.31
组别	血钙（mmol/L）		CRP（mg/L）	HOMA-IR	胎球蛋白A（μg/L）
甲亢组
治疗前	2.61±0.24^*		1.80±0.32^*	3.44±1.15^*	305.26±37.85^*
治疗后	2.41±0.14^#		1.15±0.28^#	2.25±0.29^*#	125.22±20.51^#
正常对照组	2.40±0.19		1.17±0.37	2.14±0.27	120.57±22.59