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甲状腺切除术和初级甲状腺功能障碍患者发生糖尿病的风险
Xiaodong Liu1, David Tak Wai Lui2, Xi Xiong3,4,5
1Division of Endocrine Surgery, Department of Surgery, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
JAMA surgery
|August 27, 2025
概括
甲状腺切除术显著降低了患有原发性甲状腺功能障碍 (PHPT) 的患者患糖尿病的风险. 这种益处在年轻人和患有更严重疾病的人群中更为明显.
科学领域:
- 内分泌学
- 代谢健康
- 手术的结果
背景情况:
- 原发性甲状腺功能障碍 (PHPT) 与代谢障碍有关,包括胰岛素耐药性,葡萄糖不耐受性和糖尿病.
- 甲状腺切除术对大量患者糖尿病风险的影响仍未得到充分评估.
研究的目的:
- 在被诊断为PHPT的患者中,研究甲状腺切除术与糖尿病发病率之间的独立关联.
- 评估PHPT中的手术是否会影响未来的糖尿病风险.
主要方法:
- 在2006年至2023年期间,香港一项全境的队列研究确定了3135名PHPT患者.
- 患者被分为手术 (副甲状腺切除术) 和非手术组,并对发生的糖尿病进行随访.
- 使用治疗权重的逆概率和考克斯回归分析来评估相关性.
主要成果:
- 甲状腺切除术与发生糖尿病的风险显著降低 (HR,0. 68;95% CI,0. 65- 0. 71;P < . 001).
- 在年轻患者 (年龄 ≤65岁) 和患有更严重PHPT (更高的PTH或水平) 患者中,保护作用更为明显.
- 敏感性和子组分析证实了这些发现.
结论:
- 甲状腺切除术与PHPT患者发生糖尿病的风险降低有关.
- 这些发现表明副甲状腺切除术可能有额外的代谢益处,特别是在特定的患者小组中.
- 进一步的研究可能会阐明这些代谢改善背后的机制.
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