背景:1型糖尿病与甲状腺自身免疫之间的联系已得到充分描述。到目前为止,2型糖尿病的结果参差不齐,情况并非如此。我们调查了加纳2型糖尿病患者中甲状腺自身免疫的患病率和决定因素。
方法:这是一项病例对照研究,涉及302名2型糖尿病患者和310名40-80岁的非糖尿病对照。获得人体测量和血压测量。分析空腹样本的葡萄糖,甲状腺功能,甲状腺球蛋白和甲状腺过氧化物酶的抗体.
结果:在T2DM受试者中,甲状腺自身免疫的患病率明显较高(12.2%vs.3.9%,p=0.0004)。在T2DM受试者中,44(14.7%)的TPOAb检测呈阳性,5(1.7%)对TGAb测试为阳性,15(5.0%)对两种自身抗体测试为阳性。女性T2DM受试者甲状腺自身免疫风险比男性增加3倍(OR:3.16,p=0.004),甲状腺功能亢进的T2DM患者甲状腺自身免疫风险增加41%(OR:1.41,p<0.001),亚临床甲状腺功能亢进使甲状腺自身免疫风险增加2倍,(OR:2.19,p<0.001),亚临床甲状腺功能减退会使自身免疫风险增加4倍,(OR:3.5795%p<0.0001),甲状腺功能减退与甲状腺自身免疫风险增加61%相关(OR:1.61,1.35-2.23).血脂异常与甲状腺自身免疫风险增加44%相关(OR:1.44,p=0.01),HbA1c百分比增加与甲状腺自身免疫风险增加46%相关(OR:1.46,p<0.0001)。
结论:我们观察到,与一般人群相比,加纳T2DM受试者的甲状腺自身免疫患病率较高。2型糖尿病患者的甲状腺自身免疫与女性显著相关,甲状腺功能异常,血脂异常和血糖控制不良。
BACKGROUND: The link between type 1 diabetes and thyroid autoimmunity is well described. The same cannot be said for type 2 diabetes where results have been mixed so far. We investigated the prevalence and determinants of thyroid autoimmunity among Ghanaian type 2 diabetes patients.
METHODS: This was a
case-control study involving 302 type 2 diabetes patients and 310 non - diabetic controls aged 40-80 years. Anthropometric and blood pressure measurements were obtained. Fasting samples were analyzed for glucose, thyroid function, and antibodies to thyroglobulin and thyroid peroxidase.
RESULTS: The prevalence of thyroid autoimmunity was significantly higher among T2DM subjects (12.2% vs. 3.9%, p = 0.0004). Among T2DM subjects, 44 (14.7%) tested positive for TPOAb, 5 (1.7%) tested positive for TGAb and 15 (5.0%) tested positive for both autoantibodies. Females T2DM subjects showed a 3-fold increased risk of thyroid autoimmunity compared to males (OR:3.16, p =0.004), T2DM subjects with hyperthyroidism had a 41% increased risk of thyroid autoimmunity (OR: 1.41, p < 0.001), sub-clinical hyperthyroidism increased the risk of thyroid autoimmunity by 2 fold, (OR:2.19, p < 0.001), subclinical hypothyroidism increased the risk of autoimmunity by 4-fold, (OR:3.57 95% p < 0.0001), and hypothyroidism was associated with a 61% increased risk of thyroid autoimmunity (OR: 1.61,1.35-2.23). Dyslipidaemia was associated with a 44% increased risk of thyroid autoimmunity (OR: 1.44, p = 0.01) and a percentage increase in HbA1c was associated with 46% increased risk of thyroid autoimmunity (OR:1.46, p < 0.0001).
CONCLUSIONS: We observed a high prevalence of thyroid autoimmunity in Ghanaian T2DM subjects compared to the general population. Thyroid autoimmunity in T2DM subjects was significantly associated with female gender, thyroid dysfunction, dyslipidaemia and poor glycemic control.