The Association Between Subclinical Hypothyroidism And Carotid Atherosclerosis And Diabetic Kidney Disease In Type 2 Diabetic Patients

Objective:To investigate the association between subclinical hypothyroidism(SCH) and carotid atherosclerosis(CAS) and diabetic kidney disease(DKD) in type 2 diabetic patients.Methods:A total of 310 individuals with type 2 diabetes from the first hospital of Shanxi Medical University department of Endocrinology hospital in the 2015 august-2015 december months were enrolled. The patients included 182 males and 128 females.Collected patients’ general information including: gender, age, diabetes duration, duration of hypertension, smoking history, blood pressure, height, weight, and calculating BMI.Detection in patients with biochemical indicators included: free triiodothyronine(FT3),free thyroxine(FT4), thyroid stimulating hormone(TSH), fasting plasma glucose(FPG),glycosylated hemoglobin(Hb A1c), total cholesterol(TC), triglyceride(TG), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), serum creatinine(SCr), hypersensitive c-reactive protein(hs-CRP) and so on. On the basis of SCr value calculated glomerular filtration rate(e GFR). Determined urinary albumin and urine creatinine, and then calculated the ratio(UACR). DKD was defined as UACR≥30mg/g or with diabetic retinopathy combined e GFR abnormaled. Carotid artery colour to exceed to obtain intima-media thickness(IMT) and plaque formation. CAS was defined as IMT≥1.0mm or merge with distinct patches. Patients were divided into 2 groupsaccording to thyroid function: simple T2 DM group and T2 DM with SCH group.Comparison of two groups’ metabolic indicators and differences of CAS and DKD.Logistic regression analysis to investigate the correlation of SCH and CAS and DKD. All the data were processed with statistical software packages SPSS 20.0.Results:1.The serum levels of TG, TC and hs-CRP were significantly higher in T2 DM with SCH group than those in simple T2 DM group,the comparison has statistically significant differences(P<0.05). The comparison of gender, age, diabetes duration, duration of hypertension, smoking history, BMI, SBP, DBP, FPG, Hb A1 c, HDL-C, LDL-C in the two groups has no statistically significant differences(P>0.05).2.Compared with simple T2 DM group, T2 DM with SCH group had a higher proportion of CAS and DKD, the comparison has statistically significant differences(P<0.05).3.Logistic regression analysis showed that after adjustment for gender, age, diabetes duration, BMI, hypertension, smoking, and TC, SCH was associated with CAS(OR=2.364, P<0.05).4.Logistic regression analysis showed that after adjustment for gender, age, diabetes duration, BMI, hypertension, SBP, Hb A1 c, and TG, SCH was associated with DKD(OR=2.053, P<0.05).Conclusion:1.Patients with T2 DM and SCH will have a higher incidence of CAS, SCH may be independently associated with CAS in T2 DM patients.2.Patients with T2 DM and SCH will have a higher incidence of DKD, SCH may be independently associated with DKD in T2 DM patients.