Relationship Between Carotid Intima-media Thickness And C-peptide In Diabetic Patients With Subclinical Hypothyroidism

Diabetes and thyroid diseases are most common in endocrine and metabolic diseases.The prevalence of subclinical hypothyroidism in type 2 diabetes is significantly higher.Hyperglycemia is easy to cause atherosclerosis,and dyslipidemia caused by subclinical hypothyroidism can also promote the occurrence and development of atherosclerosis.Carotid intima media thickness(IMT)is an early indicator of atherosclerosis.The level of serum C peptide can objectively and comprehensively reflect the functional changes of islet beta cells,and is related to microangiopathy.However,the relationship between C peptide and diabetic macrovascular complications is still controversial.Objective:In type 2 diabetic patients with subclinical hypothyroidism patients as the research object,to explore the relationship among carotid intima-media thickness and C peptide,further the relationship between subclinical hypothyroidism and carotid atherosclerosis verification,explore the relationship between intima-media thickness and C peptide level and atherosclerosis risk factors,further clinical guidance.Methods:Type 2 diabetes from December 2015 to July 2017 in the Department of endocrinology of Affiliated Hospital of Chengde Medical College in 119 cases with subclinical hypothyroidism patients as the research object,according to the IMT of carotid artery into the thickness of the carotid artery IMT group(Study Group)(IMT>0.9mm)62 cases and non thickening group(control group)(IMT = 0.9mm)and 57 cases.Measurement of body mass index(BMI),two groups of blood pressure systolic blood pressure(SBP),diastolic blood pressure(DBP),serum total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-c),low density lipoprotein cholesterol(LDL-c),fasting blood glucose(FPG),2h postprandial blood glucose(PPG),glycosylated hemoglobin(HbAlc),blood uric acid(UA),platelet count(PLT),fasting serum C peptide(FC-P),2 h postprandial serum C peptide(2h C-P),the clinical data were statistically analyzed.Results:1.There was a significant difference in fasting C-peptide between carotid IMT thickening group and normal IMT group in patients with diabetes and subclinical hypothyroidism(P = 0.021).2.Linear correlation analysis showed that IMT was negatively correlated with C peptide in patients with diabetes and subclinical hypothyroidism(r=-0.239,P=0.009).3.Logistic regression analysis showed that serum C-peptide was a protective factor for atherosclerosis(P = 0.016)and smoking was a risk factor for atherosclerosis in patients with diabetes and subclinical hypothyroidism(P = 0.044).Conclusion:In patients with type 2 diabetes mellitus with subclinical hypothyroidism,IMT is negatively correlated with C-peptide.A decrease in serum C-peptide levels may increase the risk of developing atherosclerosis in type 2 diabetic patients.