老年2型糖尿病患者合并亚临床甲状腺功能减退症现状及危险因素分析

Analysis of Current Status and Risk Factors of Subclinical Hypothyroidism in Elderly Patients with Type 2 Diabetes Mellitus

摘要: 目的：对老年2型糖尿病患者是否存在亚临床甲状腺功能减退症进行临床筛查，了解其发生亚临床甲状腺功能减退症情况，并分析老年2型糖尿病患者存在亚临床甲状腺功能减退症的危险因素。方法：本研究采用随机抽样法选取2024年1月至2024年11月在吴起县人民医院住院部就诊的患者，并通过转诊于乡镇卫生院管理的老年2型糖尿病患者。采用一般资料调查表(甲状腺功能相关指标等以当年在吴起县人民医院住院化验的结果为准，甲状腺功能相关化验指标由主管医生诊断)收集相关资料。本研究采用SPSS 26.0软件统计分析，计量资料符合正态分布采用($\overline{X}\pm s$ )描述；计数资料用频数与构成比((n)%)来描述，组间比较采用c²检验；以患者是否存在亚临床甲状腺功能减退症为因变量，将单因素分析中有统计学意义的变量纳入二元Logistic回归进行分析老年2型糖尿病患者合并亚临床甲状腺功能减退症的危险因素，以P < 0.05为差异具有统计学意义。结果：本研究共纳入324例老年2型糖尿病患者，其中存在亚临床甲状腺功能减退症的为31例，发生率为9.6%。二元Logistic回归分析，结果显示，性别(OR = 4.993)、年龄(OR = 2.743)、合并周围神经病变(OR = 5.551)、合并大血管病变(OR = 4.536)4个变量进入方程。结论：性别、年龄、合并周围神经病变、合并大血管病变是老年2型糖尿病患者存在亚临床甲状腺功能减退症的独立危险因素。针对老年2型糖尿病患者，特别是女性、高龄患者需要定期监测其血糖和甲状腺功能，综合考虑患者的糖尿病大血管病变、周围神经病变等各种慢性并发症血管危险因素，制定个性化的治疗与护理方案，及时调整治疗方案，指导患者采取健康的生活方式，提高其生活质量。

Abstract: Objective: To conduct clinical screening for subclinical hypothyroidism in elderly patients with type 2 diabetes mellitus, to understand the occurrence of subclinical hypothyroidism, and to analyze the risk factors of subclinical hypothyroidism in elderly patients with type 2 diabetes mellitus. Methods: In this study, a random sampling method was used to select the patients who were admitted to the inpatient department of Wuqi County People’s Hospital from January to November 2024, and the elderly patients with type 2 diabetes mellitus were referred to township health centers. A general data questionnaire (thyroid function-related indicators were based on the results of in-patient laboratory tests in Wuqi County People’s Hospital that year, and thyroid function-related laboratory indicators were diagnosed by the doctor in charge) was used to collect relevant data. In this study, SPSS 26.0 software was used for statistical analysis, and measurement data conforming to normal distribution ($\overline{X}\pm s$ ) were described. Counting data were described by frequency and component ratio ((n)%), and inter-group comparison was performed by c² test; Taking the presence or absence of subclinical hypothyroidism in patients as the dependent variable, variables with statistical significance in univariate analysis were included in binary logistic regression for analyzing the risk factors of subclinical hypothyroidism in elderly patients with type 2 diabetes mellitus, with P < 0.05 considered as statistically significant. Results: A total of 324 elderly patients with type 2 diabetes mellitus were included in this study, of which 31 had subclinical hypothyroidism (9.6%). Binary Logistic regression analysis showed that gender (OR = 4.993), age (OR = 2.743), peripheral neuropathy (OR = 5.551) and macrovascular disease (OR = 4.536) were included in the equation. Conclusion: Gender, age, peripheral neuropathy and macrovascular disease are independent risk factors for subclinical hypothyroidism in elderly patients with type 2 diabetes mellitus. For elderly patients with type 2 diabetes mellitus, especially women and elderly patients, it is necessary to regularly monitor their blood glucose and thyroid function, comprehensively consider the vascular risk factors of various chronic complications such as diabetic macrovascular disease and peripheral neuropathy, formulate personalized treatment and nursing plans, timely adjust treatment plans, guide patients to adopt a healthy lifestyle and improve their quality of life.