A high thyroid stimulating hormone level is associated with diabetic peripheral neuropathy in type 2 diabetes patients
A high thyroid stimulating hormone level is associated with diabetic peripheral neuropathy in type 2 diabetes patients
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高促甲状腺激素水平与 2 型糖尿病患者的糖尿病周围神经病变相关
DOI：
10.1016/j.diabres.2016.01.018
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发表时间：
2016-05-01
影响因子：
5.1
通讯作者：
Jia, Weiping
中科院分区：
文献类型：
--
作者：
Zhao, Weijing;Zeng, Hui;Jia, Weiping
目的：促甲状腺激素(TSH)与2型糖尿病(T2 DM)的关系已为人们所熟知。然而，TSH是否与糖尿病周围神经病变(DPN)有关还没有研究。本研究的目的是探讨中国2型糖尿病患者TSH与DPN的关系。亚临床甲状腺功能减退症(SCH)被定义为TSH水平升高(>；4.0mIU/L)和游离甲状腺激素水平正常。结果：DPN患者血清TSH水平明显高于非DPN T2 DM患者(P均<0.01)。SCH组DPN患病率及DPN体征均高于甲状腺功能正常组(P均<0.01)。Spearman相关分析显示，血清TSH水平与糖尿病周围神经营养呈正相关(r=0.172，P<0.01)。在调整潜在的混杂变量后，多元Logistic回归分析发现促甲状腺激素与糖尿病周围神经营养之间存在显著的独立关联[优势比(OR)=1.365，P<；0.01]。根据TSH水平将患者分成四分位数。与四分位数1相比，四分位数2(P<；0.01)、四分位数3(P=0.01)和四分位数4(P<；0.01)的患者发生DPN的风险更高。受试者-工作特征曲线分析显示，TSH值在男性为3.045 mIU/L，女性为2.94mIU/L。结论：在中国2型糖尿病人群中，促甲状腺激素水平与糖尿病周围神经营养独立相关。血清TSH水平升高可能是DPN的潜在危险因素。(C)2016爱思唯尔爱尔兰有限公司。保留所有权利。
Aim: The association between thyroid stimulating hormone (TSH) and type 2 diabetes mellitus (T2DM) is well known. However, whether TSH is related to diabetic peripheral neuropathy (DPN) has not been studied. The aim of this study was to explore the relationship between TSH and DPN in Chinese patients with T2DM.Methods: In this cross-sectional study, 605 patients with T2DM were enrolled. Subclinical hypothyroidism (SCH) was defined as an elevated TSH level (>4.0 mIU/L) and a normal free thyroxine level. DPN was evaluated by neurological symptoms, neurological signs, and electromyogram.Results: Serum TSH levels were significantly higher in DPN and signs of DPN compared with non-DPN T2DM patients (both P < 0.01). The prevalence of DPN and signs of DPN in SCH subjects was higher than that in euthyroid subjects (both P < 0.01). Spearman's correlation analysis showed that the serum TSH level was positively associated with DPN (r = 0.172, P < 0.01). A significant independent association between TSH and DPN was found by multiple logistic regression analysis after adjusting for potential confounding variables [odds ratio (OR) = 1.365, P < 0.01]. The patients were sequentially assigned to quartiles according to TSH level. Compared with quartile 1, patients in quartile 2 (P < 0.01), quartile 3 (P = 0.01), and quartile 4 (P < 0.01) had a higher risk of DPN. Receiver-operating characteristic curve analysis revealed that the optimal cutoff point of TSH to indicate DPN was 3.045 mIU/L in men and 2.94 mIU/L in women.Conclusion: TSH level is independently associated with DPN in Chinese population with T2DM. A high serum TSH level may be a potential risk factor for DPN. (C) 2016 Elsevier Ireland Ltd. All rights reserved.