Analysis Of The Prevalence And Influencing Factors Of Type 2 Diabetes Mellitus With Thyroid Disease

Objective To summarize the clinical data of patients with type 2 diabetes,and observe the prevalence of T2 DM combined with thyroid diseases,and investigate the clinical characteristics of thyroid dysfunction in the T2 DM population,and analyze the possible related risk factors in order to explore the interrelationship between type 2 diabetes mellitus and thyroid diseases,and sum up the experience for clinical diagnosis and treatment.Methods A total of 438 subjects were included in the study,including 258 patients with type 2 diabetes hospitalized in the Endocrinology and Metabolism Department three in the Second Hospital of Lanzhou University,from January to December of 2017,and at the same time,there were 180 cases of physical examination matched in the gender and age with T2 DM patients in the physical examination center of our hospital.The fasting plasma glucose,blood lipid level,blood uric acid(UA),total triiodothyronine(TT3),total thyroxine(TT4),free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH),thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPOAb)and thyroid B-ultrasound were analyzed retrospectively,and postprandial blood glucose,homocysteine(Hcy),glycated hemoglobin(Hb A1c),islet function,the urine microalbuminuria,urine creatinine,carotid duplex ultrasound,and cerebral vascular doppler ultrasound(TCD)examination results in T2 DM patients were collected,and all the above collected data were statistically analyzed with SPSS 22.0 software.Multivariate logistic regression analysis was used to explore the influencing factors of T2 DM with thyroid dysfunction.Results(1)T2DM patients had abnormal thyroid function,subclinical hypothyroidism,both TGAb and TPOAb are positive as well as thyroid nodule prevalence were higher than those of healthy subjects,and the difference was statistically significant(P< 0.05).(2)The general data and metabolic index of T2 DM patients and healthy subjects showed that:FPG,TSH levels of T2 DM patients were higher than those of healthy people,and the levels of FT3,TT3,and FT4 were lower than those of healthy people.The difference was statistically significant(P<0.05).(3)Among 258 hospitalized patients with type 2 diabetes,64 cases were diagnosed with abnormal thyroid function,and the total prevalence rate was 24.81%;45 cases had thyroid nodules,the total prevalence rate was 17.44%;46 cases with positive thyroid autoantibody,and the total prevalence rate was 17.83%.(4)There were 64 cases of T2 DM patients with thyroid dysfunction,including 4 cases of primary hypothyroidism with a prevalence rate of 1.55%;49 cases of subclinical hypothyroidism with a prevalence of 18.99%,accounting for 76.56% of type 2 diabetes mellitus combined with thyroid dysfunction;4 cases of primary hyperthyroidism,the prevalence was 1.55%;7 cases of subclinical hyperthyroidism,the prevalence was 2.72%.(5)The prevalence of subclinical hypothyroidism,TGAb positive,both TGAb and TPOAb are positive in women with T2 DM was significantly higher than that of men,the differences also had statistical significance(P< 0.05).(6)Comparison of the clinical data of T2 DM patients with abnormal thyroid function and those with normal thyroid function showed that the levels of FPG,Hb A1 c,HOMA-IR,TC,TG and TSH were higher in T2 DM patients with thyroid dysfunction than those with normal thyroid function.The difference was statistically significant(P<0.05).The prevalence of female,both TGAb and TPOAb are positive in T2 DM patients with abnormal thyroid function was higher than that in normal thyroid function patients(P<0.05).(7)When controlling age,duration of diabetes,FPG,BMI,TC,TG,TSH,diabetic nephropathy and insulin therapy,results of multivariate logistic regression analysis showed that females,both TGAb and TPOAb are positive,HbA1 c and HOMA-IR were risk factors for T2 DM patients combined with thyroid dysfunction(P< 0.05).Conclusion(1)The prevalence rate of T2 DM with thyroid disease is higher and more common in clinic.The prevalence rate of thyroid dysfunction is 24.81%,and subclinical hypothyroidism is the most common.(2)In patients with T2 DM who were subclinically hypothyroidism,positive for TGAb,and positive for TGAb and TPOAb,the prevalence was higher in women than in men.(3)T2DM patients with poor glycemic control and women who were positive for TGAb and TPOAb are more likely to have thyroid dysfunction.In clinical practice,clinicians should pay attention to the early screening of thyroid function in T2 DM patients,especially for female patients with thyroid autoantibodies and poor blood glucose control.Routine monitoring of thyroid function should be performed so as to avoid missed diagnosis leading to the delay of the disease.