关键词: 桥本甲状腺炎, 内脏脂肪面积, 同型半胱氨酸, 亚临床甲状腺功能减退症, 影响因素

Abstract:

Objective　To explore the correlation of visceral fat area (VFA) and serum homocysteine (Hcy) with subclinical hypothyroidism (SCH) in patients with Hashimoto's thyroiditis (HT). Methods　A total of 194 patients with HT admitted to Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from March 2023 to November 2024 were selected for the case control study. According to whether the patients were complicated with SCH, they were divided into a combined group (38 cases) and a non-combined group (156 cases). The VFA and serum Hcy level were measured in all the patients, and the clinical related data were collected. χ² test and t test were used to compare the clinical data. The logistic regression analysis was used to analyze the independent influencing factors. The receiver operating characteristic curve (ROC) was used to analyze the diagnostic value. The Pearson method was used to analyze the correlation. Results　The age [(61.31±4.72) years vs. (57.36±4.78) years], proportion of females [92.11% (35/38) vs. 72.44% (113/156)], levels of thyroid peroxidase antibody (TPOAb) [(55.48±6.16) IU/ml vs. (52.43±5.83) IU/ml] and thyroid stimulating hormone (TSH) [(5.81±1.20) uIU/ml vs. (3.24±1.05) uIU/ml], VFA [(87.36±24.96) cm² vs. (60.44±17.28) cm²], and levels of Hcy [(17.21±4.30) mmol/L vs. (11.54±2.87) mmol/L] and thyroglobulin antibody (TgAb) [(46.32±5.15) IU/ml vs. (43.87±4.87) IU/ml] in the combined group were higher than those in the non-combined group (t=4.579, P<0.001; χ²=6.535, P=0.011; t=2.860, P=0.005; t=13.148, P<0.001; t=7.831, P<0.001; t=9.808, P<0.001; t=2.750, P=0.007). The logistic regression analysis showed that age (OR=2.031, 95%CI 1.178-3.502), gender (OR=3.218, 95%CI 1.229-8.424), TSH level (OR=2.375, 95%CI 1.555-3.626), VFA (OR=6.089, 95%CI 2.197-16.872), and Hcy level (OR=4.642, 95%CI 2.296-9.381) were independent influencing factors for SCH in the patients (all P<0.04). The ROC showed that the sensitivities of VFA, Hcy, and their combination in the diagnosis of SCH in the patients were 71.10%, 73.70%, and 86.80%, respectively; the specificities were73.10%, 75.00%, and 91.70%, respectively;the areas under the curves were 0.781, 0.807, and 0.918, respectively (all P<0.001). VFA and Hcy level were positively correlated with TSH levels in the HT patients with SCH (r=0.632 and 0.577; P=0.001 and 0.003). Conclusions　VFA and Hcy are independent risk factors for SCH in patients with HT; their levels are positively correlated with the serum TSH level in patients with HT combined with SCH, and have certain diagnostic value for the occurrence of SCH in patients with HT.

Key words: Hashimoto's thyroiditis,  , Visceral fat area,  , Homocysteine,  , Subclinical hypothyroidism,  , Influencing factors