傅艳莉,范良敏,时立新,张巧,彭年春,胡颖
FU Yanli,FAN Liangmin,SHI Lixin,ZHANG Qiao,PENG Nianchun,HU Ying

• 1:贵州医科大学
• 2:贵州医科大学附院内分泌代谢病科

摘要(Abstract)：

目的:探讨绝经后女性血清促甲状腺激素(TSH)与代谢综合征(MS)的相关性。方法:采用整群随机抽样的方法,对贵阳市云岩区10 140名受试者进行横断面流行病学调查,共纳入5 230名绝经后女性,每名受试者均进行详细的问卷调查及体格检查,抽取静脉血检测血清TSH、空腹血糖(FPG)、餐后2 h血糖(2h PG)、空腹胰岛素浓度(FINS)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)等生化指标;根据TSH的参考范围将受访者分为TSH降低组、正常组及升高组(n=1 135),根据2005年IDF标准将受访者再分为MS组(n=2 439)和非MS组(n=2 791),比较不同分组受试者的一般资料和部分血生化指标的变化,采用多元线性回归模型分析血清TSH与MS及其组分的相关性。结果:共2 439名绝经女性符合MS诊断,MS患病率为46.6%;通过多元线性回归分析,校正年龄、BMI及HOMA-IR后,血清TSH与TC、TG、LDL-C均呈正相关(P<0.05),不同血清TSH水平高血糖、高血压、向心性肥胖及MS的患病率比较,差异无统计学意义(P>0.05),TSH升高组受访者高TG血症患病率高于TSH正常组(P<0.05)。结论:贵阳市绝经后女性MS的患病率高,血清TSH升高主要影响TG水平,但血清TSH水平与MS的患病无关。
Objective: To investigate the relationship between serum thyroid stimulating hormone( TSH) and metabolic syndrome( MS) in postmenopausal women. Methods: A cross-sectional epidemiological survey of 10 140 subjects in Yunyan district of Guiyang was conducted by cluster random sampling. A total of 5 230 postmenopausal women were enrolled,and each subject was given a detailed questionnaire and physical examination. Meanwhile,venous blood was extracted to detect serum TSH,fasting blood glucose( FPG),2 h postprandial blood glucose( 2h PG),fasting insulin( FINS),triglyceride( TG),total cholesterol( TC),high density lipoprotein cholesterol( HDL-C) and low density lipoprotein cholesterol( LDL-C) and other biochemical indicators. According to TSH reference range,all subjects were divided into three groups,including low TSH group( 80 subjects),normal TSH group( 4 015 subjects) and high TSH group( 1 135 subjects). According to MS IDF diagnostic criteria in 2005,subjects were divided into MS group( 2 439 subjects) and non-MS group( 2 791 sub-jects). The general data and the changes of some blood biochemical indexes in different groups were compared. The correlation between serum TSH and MS and its components was analyzed by multiple linear regression model. Results: 2 439 postmenopausal women suffered from MS,and the prevalence of MS was 46. 6%. After correction for age,BMI and HOMA-IR,multiple linear regression analysis showed that serum TSH level and TC,TG and LDL-C presented the positive correlation( P < 0. 05).The prevalence of hyperglycemia,hypertension,central obesity,and MS in patients with different serum TSH level had no obvious difference( P > 0. 05). The difference of the prevalence of high blood TG between high TSH group and normal TSH group was obvious( P < 0. 05). Conclusion: The prevalence of MS in postmenopausal women in Guiyang is high,increase of serum TSH level mainly influences TG level,serum TSH level had no correlation with prevalence of MS.

关键词(KeyWords)： 绝经;促甲状腺素;甲状腺功能试验;代谢综合征;流行病学
menopause;thyroid stimulating hormone;thyroid function;metabolic syndrome;epidemiology

Abstract:

Keywords:

基金项目(Foundation): 贵州省省长资金临床应用课题专项研究(黔省专合字2012-100号)

作者(Author): 傅艳莉,范良敏,时立新,张巧,彭年春,胡颖
FU Yanli,FAN Liangmin,SHI Lixin,ZHANG Qiao,PENG Nianchun,HU Ying

DOI: 10.19367/j.cnki.1000-2707.2017.06.022

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