| Objective: To study the relationship between thyroid function and diabetic retinopathy in patients with type 2 diabetes mellitus with normal thyroid function.Methods: According to the REACTION project initiated by the Chinese Medical Association,we chose from Dalian community residents from August 2011 to December of the same year.Selecting ages greater than or equal to 40 years old,excluding non-diabetic patients,incomplete clinical information,abnormal thyroid function and other factors eventually led to the analysis of 1132 subjects.They were tested in fasting plasma glucose(FPG)?two-hour postprandial blood glucose(2h PG)?glycated hemoglobin(Hb A1c)?fasting insulin(FINS)?low-density lipoprotein cholesterol(LDL-C)? high-density lipoprotein cholesterol(HDL-C)?Total cholesterol(TC)?triglyceride(TG)? Serum free triiodothyronine(FT3)?serum free thyroxine(FT4)?serum thyroid stimulating hormone(TSH)?Thyroid peroxidase antibody(TPO-AB).Besides,their height,weight,waist circumference,hip circumference,heart rate,systolic and diastolic blood pressure as well as pulse rate were measured and their average blood pressure?average pulse rate?BMI?waist-to-hip ratio as well as theHOMA-IR were calculated.We adopted non-mydriatic fundus camera to diagnose whether they were suffering with diabetic retinopathy or not.Patients with type 2diabetes mellitus with normal thyroid function were divided into NDR group and DR group according to whether DR occurred or not,and the differences between the two groups were compared.According to the FT3 and FT4 quartile levels,the enrollees are divided into four groups: Q1,Q2,Q3 and Q4;q1,q2,q3 and q4 are four groups,and the number of DRs in DRs of FT3 and FT4 quartiles and DR are compared.Whether there is a difference in the prevalence rate.Spearman correlation analysis and binary logistic regression were used to analyze the correlation between thyroid function and DR.Results:1.Among 1132 T2 DM patients with normal thyroid function,149 had diabetic retinopathy,the incidence rate was 13.16%.The course of disease,age,systolic blood pressure,WHR,FPG,2h PG,Hb A1 c,HOMA-IR,FT4 were all in DR group.Higher than the non-DR group.The BMI and FT3 indicators were lower than those in the non-DR group(P<0.05).2.FT3 of T2 DM patients with normal thyroid function were divided into four groups according to quartile,Q1 group(FT3<4.03pmol/L),Q2 group(4.03pmol/L?FT3<4.30pmol/L),Q3 group(4.30)Pmol/L ? FT3 < 4.58 pmol / L),Q4group(FT3 ? 4.58 pmol / L),the number of people with DR in the four groups and the prevalence rate were 56(20.4%),38(13.4%),30(10.5%)),25(8.7%),the difference in prevalence between the four groups was statistically significant(?2=19.252,P=0.000).Comparing the two groups,the results showed that Q1 and Q2 groups(?2=4.739,P=0.029),Q1 and Q3 groups(?2=10.531,P=0.001),Q1 and Q4 groups(?2 = 15.459,P= 0.000 The difference in prevalence rates was statistically significant.There was no significant difference in the prevalence of DR among the FT4 groups(P>0.05).3.Spearman correlation analysis showed a positive correlation between DR and FT4,disease duration,age,MSBP,WHR,Hb A1 c,FPG,2h PG,HOMA-IR(correlation coefficients were r = 0.062,r = 0.089,r = 0.073,r = 0.099,r = 0.09,r = 0.249,r = 0.231,r = 0.201,r = 0.107,P < 0.05),negatively correlated with FT3(r =-0.126,P < 0.05).4.With or without DR as dependent variable and FT3 as independent variable,binary Logistic regression analysis was carried out.Logistic regression analysis showed that when no risk factors were adjusted,FT3 was significantly correlated with DR,the difference was statistically significant(P < 0.05).After the correction of age,disease duration,blood glucose,and Hb A1 c,the correlation between FT3 and DR was not statistically significant(P=0.489).Finally,the course of disease and glycated hemoglobin entered the equation,and the regression equation was obtained: DR=-2.508+ 0.156 Hb A1 c + 0.032 course of disease.With or without DR as dependent variable and FT4 as independent variable,binary Logistic regression analysis was carried out.Logistic regression analysis showed that when no risk factors were adjusted,FT4 was significantly correlated with DR,the difference was statistically significant(P < 0.05).After the correction of age,disease duration,blood glucose,and Hb A1 c,the correlation between FT4 and DR was not statistically significant(P=0.843).Finally,the course of disease and glycated hemoglobin entered the equation,and the regression equation was obtained: DR=-2.504 + 0.154 Hb A1 c + 0.034 course of disease.Conclusions:1.In the type 2 diabetes mellitus of the Dalian community with normal thyroid function,the FT3 level and the FT4 level were increased in the DR group compared with the non-DR group.2.There was no correlation between FT3,FT4,TSH and the occurrence of diabetic retinopathy.3.The course of disease,glycosylated hemoglobin was positively correlated with the occurrence of diabetic retinopathy. |
PDF Full Text Request