Relationship Between Different Thyroid Function Status And Carotid Atherosclerosis In Patients With Type 2 Diabetes Mellitus

Objective:By analyzing the correlation between different thyroid function and carotid atherosclerosis in patients with type 2 diabetes mellitus(T2DM),to understand the relationship between thyroid disease and diabetic great vessel complications,and to provide new ideas for the prevention and treatment of diabetic great vessel complications.Methods:Collected the clinical data of 702 T2DM patients,whose were hospitalized to the Department of Endocrinology and Metabolism of the First Affiliated Hospital of Nanchang University from December 2019 to December 2022.The results included patient age,gender,disease course,smoking history,body mass index(BMI),fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG),glycated hemoglobin(HbA1c),cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),uric acid(U A),C-reactive protein(CPR),mean platelet volume(MPV),fibrinogen(FIB),thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroxine(FT4),anti-thyroglobulin antibody(TGAb),anti-thyroperoxidase antibody(TPOAb)and carotid artery color Doppler ultrasound.According to thyroid function,the patients were divided into T2DM+normal thyroid function group(normal thyroid function group),T2DM+hyperthyroidism group(hyperthyroidism group),T2DM+hypothyroidism group(hypothyroidism group),and T2DM+subclinical hypothyroidism group(SCH group).Each index among the different groups were compared,and used the ordered multiclassification logistics regression to analyze the independent risk factors,which affecting carotid atherosclerosis.Results:1.The male proportion,smoking proportion and HDL-C level in normal thyroid function group were significantly higher than those in hypothyroidism group and SCH group(P<0.017),and the age,duration of diabetes,SBP,FPG,HbAlc,TC,TG,LDLC and thyroid antibody positive rates were significantly lower than those in hypothyroidism group and SCH group(P<0.017);The DBP and MPV of normal thyroid function group were lower than those of SCH group(P<0.017),and FIB was significantly lower than that of hypothyroidism group(P<0.017);The positive rate of thyroid antibody in SCH group was lower than that in hypothyroidism group(P<0.017);The levels of SBP,HbAlc,FIB,and the positive rates of thyroid antibody in hyperthyroidism group were significantly higher than those in normal thyroid function group(P<0.05),while TC and HDL-C were significantly lower than those in normal thyroid function group(P<0.05).2.The detection rate of carotid plaque in the hypothyroidism group、SCH group and hyperthyroidism group was significantly higher than that in normal thyroid function group(P<0.05).3.The logistic regression were showed that when T2DM patient with hypothyroid or SCH:age(OR=1.083,P<0.05)、male(OR=1.956,P<0.05)、SBP(OR=1.023,P<0.05)、LDL-C(OR=1.576,P<0.05)、TSH(OR=1.054,P<0.05)were independent risk related factors for carotid atherosclerosis.When T2DM patient with hyperthyroidism:age(OR=1.123,P<0.05)、SBP(OR=1.061,P<0.05)、HbAlc(OR=1.354,P<0.05)、LDL-C(OR=4.246,P<0.05)were independent risk related factors for carotid atherosclerosis,while negative TGAb(OR=0.230,P<0.05)was a protective related factor.Conclusions:1.Hyperthyroidism、hypothyroidism and subclinical hypothyroidism all increase the risk of carotid atherosclerosis in T2DM patients.2.When T2DM patient with hypothyroid or SCH:age、male、SBP、LDL-C、TSH were independent risk related factors for carotid atherosclerosis.When T2DM patient with hyperthyroidism:age、SBP、HbAlc、LDL-C were independent risk related factors for carotid atherosclerosis,while negative TGAb was a protective related factor.