关键词: 糖尿病, 2型, 甲状腺自身抗体, 甲状腺激素, 血红蛋白A, 糖基化

Abstract: Background　The prevalence of abnormal changes of thyroid hormones and elevated thyroid antibodies has been recently found to be higher in type 2 diabetics than that of non-type 2 diabetics.As thyroid disease-induced harm on physical health in the real world is similar to that of diabetes-related complications and comorbidities in type 2 diabetics，treating diabetes via improving abnormal changes of thyroid hormones and antibodies has become a concern issue.Objective　To explore the abnormal changes of serum thyroid hormones and antibodies in type 2 diabetics.Methods　172 type 2 diabetics（type 2 diabetes group） were recruited from Department of General Medicine，the First Hospital of China Medical University from April 2018 to March 2019，and were compared to 160 non-type 2 diabetics（control group）.Data were collected，including gender，age，duration of diabetes，HbA1c，history of hypertension，TC，TG，LDL，HDL，TPOAb，TGAb，TSH，FT3，and FT4.Thyroid hormones and antibodies were compared between diabetics and control groups，and were compared between the diabetics by duration of type 2 diabetes〔<1 year（n=19），1-10 years（n=69），>10 years（n=84）〕，HbA1c〔≤6.5%（n=67），6.5%<HbA1c<9.0%（n=84），≥9.0%（n=21）〕，gender〔men（n=90） and women（n=82）〕 and prevalence of hypertension〔hypertension（n=110） and non-hypertension （n=62）〕.Results　Type 2 diabetes group had higher average levels of TPOAb and TGAb and lower average level of FT3 than the control group （P<0.05）.TGAb and FT3 differed significantly among diabetics by the duration of diabetes（P<0.05）.In particular，those with over 10 years' duration of diabetes had higher average TGAb level than those had less than 1-year duration（P<0.05），and had lower average level of FT3 than those with 1-10-year duration（P<0.05）.TGAb level differed significantly among diabetics by the HbA1c level （P<0.05）.In particular，those with HbA1c greater than 6.5% but lower than 9.0% had higher average TGAb than those with HbA1c≤6.5% （P<0.05）.The average TGAb and TSH levels of male diabetics were lower than those of female diabetics （P<0.05）.The average FT4 level of hypertensive diabetics was higher than that of non-hypertensive diabetics （P<0.05）.Spearman correlation analysis showed that TGAb was positively correlated with age，duration of diabetes，and HbA1c （P<0.05）；TSH was positively correlated with TG （P<0.05）；FT3 was negatively correlated with age and duration of diabetes （P<0.05），but was positively correlated with TC and HDL （P<0.05）.Conclusion　Type 2 diabetics are more likely to have thyroid hormone abnormalities and elevated thyroid antibodies，which may be associated with the duration of diabetes，HbA1c，gender，and hypertension.As a result，type 2 diabetics，especially women with long duration of diabetes，poor glycemic control，and hypertension should pay more attention to the screening of thyroid hormones and antibodies.

Key words: Diabetes mellitus, type 2；Thyroid autoantibodies；Thyroid hormone；Hemoglobin A, glycosylated