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甲状腺激素变化与2型糖尿病发生之间的关联使用纵向和时间到事件数据的联合模型:在德黑兰甲状腺研究中,超过十年的随访
Alireza Amirabadizadeh1, Ladan Mehran1, Atieh Amouzegar1
1Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Frontiers in endocrinology
|December 30, 2024
概括
增加的甲状腺刺激激素 (TSH) 和下降的自由甲状腺素 (FT4) 水平与患2型糖尿病 (T2DM) 的风险降低有关. 监测甲状腺激素可能有助于T2DM预防策略.
科学领域:
- 内分泌学 在内分泌学.
- 代谢健康 代谢健康
- 流行病学 流行病学
背景情况:
- 2型糖尿病 (T2DM) 是一个主要的全球健康问题,具有显著的发病率和死亡率.
- 甲状腺疾病很常见,与代谢健康有关,但它们与T2DM风险的关联是有争议的.
- 之前的研究显示了关于甲状腺激素水平和T2DM发病率的相互矛盾的结果.
研究的目的:
- 研究血清甲状腺刺激激素 (TSH) 和自由甲状腺素 (FT4) 水平的纵向变化与T2DM发生率之间的关联.
- 探索甲状腺功能与T2DM发展之间的动态关系.
主要方法:
- 在德黑兰甲状腺研究队列中的1938名成年人 (≥20岁) 在四个检查周期 (1999-2012) 中利用了数据.
- 模拟日志转换的TSH和FT4水平作为时间变化的暴露.
- 采用多变量调整的联合模型 (JM) 来分析与事件T2DM的关联.
主要成果:
- 在9.43年的中位数随访期间,发现了135例新的T2DM病例.
- 每个日志转化TSH的单位增加都与T2DM发病率下降25%有关 (HR:0.75;95%CI:0.64-0.90).
- 每个FT4单位的增加都显示出T2DM风险的边际显著增加 (HR:1.06;95%CI:0.99-1.13;p=0.06).
结论:
- 血清甲状腺激素的动态变化与T2DM发展有关.
- 随着时间的推移,增加TSH和减少FT4与患糖尿病的风险较低相关.
- 甲状腺激素监测可能对T2DM预防策略很重要,因为它与代谢健康的复杂相互作用.
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