目的 探讨甲状腺功能亢进患者糖化血红蛋白(HbA1c)、空腹血糖(FBG)及餐后2h血糖(2hPG)表达水平,分析其在临床评估的意义.方法 选择2020年1月-2022年12月在保定市第一中心医院接受治疗的甲状腺功能亢进患者98例,设为病例组,选择同期本院体检的85名健康体检者作为对照组.分析HbA1c、FBG及2h PG与血脂、甲状腺激素的相关性以及HbA1c、FBG及2hPG鉴别诊断甲状腺功能亢进的价值.结果 病例组血清HbA1c、FBG及2h PG高于对照组,差异均有统计学意义(t=6.294、5.208、16.485,P均＜0.05).病例组血清甘油三酯(TG)、总胆固醇(TC)、促甲状腺激素(TSH)低于对照组,游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)高于对照组,差异均有统计学意义(t=17.589、10.415、42.946、10.805、9.337,P均＜0.05).相关性分析结果中显示,血清HbA1c、FBG、2 h PG 与 TG、TC 及 TSH 均成负相关(P＜0.05),血清 HbA1c、FBG、2 h PG 与 FT3、FT4 均成正相关(P＜0.05).受试者工作特征(ROC)曲线显示,血清HbA1c诊断甲状腺功能亢进的曲线下面积(AUC)为0.711,灵敏度67.60％,特异度71.20％,截断值8.12％;血清FBG诊断甲状腺功能亢进的AUC为0.746,灵敏度69.30％,特异度73.60％,截断值5.36 mmol/L;血清2 h PG诊断甲状腺功能亢进的AUC为0.962,灵敏度82.10％,特异度88.40％,截断值6.87 mmol/L.联合检测较单独检测的AUC及灵敏度和特异度更高,差异均有统计学意义(P均＜0.05).结论 甲状腺功能亢进患者血清HbA1c、FBG及2 h PG水平表达异常,可能与甲状腺功能亢进有关,可作为甲状腺功能亢进的评估指标.
Expression and significance of HbA1c,FBG and 2h PG in patients with hyperthyroidism
Objective To study the expression and significance of glycated hemoglobin(HbA1c),fasting blood glucose(FBG)and 2 h postprandial blood glucose(2 h PG)in patients with hyperthyroidism.Methods 98 patients with hyperthyroidism who received treatment in Baoding First Central Hospital from January 2020 to December 2022 were selected as case group,85 healthy physical examinations were selected as the control group.The correlation of HbA1c,FBG and 2 h PG with blood lipid and thyroid hormone,and the value of differential diagnosis of hyperthyroidism with HbA1c,FBG and 2 h PG were analyzed.Results Serum HbA1c,FBG and 2 h PG levels in the case group were significantly higher than those in the control group(t=6.294,5.208,16.485;all P＜0.05).Serum triglyceride(TG),total cholesterol(TC)and thyroid stimulating hormone(TSH)in the case group were lower than those in the control group;free triiodothyronine(FT3)and free thyroxine(FT4)in the case group were significantly higher than those in the control group(t=17.589,10.415,42.946,10.805,9.337;all P＜0.05).Correlation analysis results showed that serum HbA1c,FBG and 2 h PG levels were negatively correlated with TG,TC and TSH levels(P＜0.05),while serum HbA1c,FBG and 2 h PG levels were positively correlated with FT3 and FT4 levels(P＜0.05).Receiver operating characteristic(ROC)results showed that the area under the curve(AUC)of serum HbA1c for the diagnosis of hyperthyroidism was 0.711,the sensitivity was 67.60％,the specificity was 71.20％,and the cut-off value was 8.12％.The AUC of serum FBG in the diagnosis of hyperthyroidism was 0.746,the sensitivity was 69.30％,the specificity was 73.60％,and the cut-off value was 5.36 mmol/L.The AUC of serum 2 h PG in the diagnosis of hyperthyroidism was 0.962,the sensitivity was 82.10％,the specificity was 88.40％,and the cut-off value was 6.87 mmol/L.The AUC,sensitivity and specificity of combined detection were higher than those of single detection(all P＜0.05).Conclusion The abnormal expression of serum HbA1c,FBG and 2 h PG levels in patients with hyperthyroidism might be related to hyperthyroidism and could be used as an evaluation indicator of hyperthyroidism.
HyperthyroidismGlycated hemoglobinFasting blood glucose2 h postprandial blood glucose
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