Analysis Of Clinical Characteristics Of Patients With Type 2 Diabetes Mellitus Complicated With Thyroid Dysfunction

Objective:To analyze the clinical characteristics of patients with type 2 diabetes mellitus(T2DM)complicated with thyroid dysfunction(TD)and its possible influencing factors.Methods:420 patients(248 males and 172 females)were randomly selected from January 2016 to October 2018,who were hospitalized in the department of endocrinology of affiliated Hospital of Qinghai University and were definitely diagnosed with T2 DM.According to thyroid function test results,patients were divided into T2 DM group(203 cases),combined with hypothyroidism group(163 cases),and combined with hyperthyroidism group(54 cases).General information and biochemical indexes,carotid intima media thickness(CMIT),thyroid color doppler ultrasound,fundus photography,and limb doppler(ABI)were recorded.SPSS23.0 system software was used for statistical processing and analysis of the above collected data.Results:(1)Among the 420 subjects,217(51.7%)patients with T2 DM combined with TD,163(38.8%)patients with hypothyroidism,and 54(12.9%)patients with hyperthyroidism were included.The prevalence rates of subclinical hypothyroidism,clinical hypothyroidism,subclinical hyperthyroidism,and clinical hyperthyroidism were 24.0%,14.8%,4.1%,and 8.8% respectively.(2)Compared with T2 DM group,the combined hypothyroidism group had older age,longer course of disease,lower proportion of smoking and drinking,lower HbA1 c,higher positive rate of TPOAb,thyroid nodules,DN,DR and CAS(P < 0.05).(3)Compared with T2 DM group,the combined hyperthyroidism group was older and had a longer course of disease.The waist circumference,BMI,smoking proportion,drinking proportion,TG and TC of the combined hyperthyroidism group were lower,the positive rate of TPOAb,thyroid nodule and CAS were higher(P < 0.05).(4)Compared with T2 DM combined hypothyroidism group,the waist circumference,BMI,TG,TC,DN detection rate of the combined hyperthyroidism group were lower,HbA1 c,positive rate of TPOAb and thyroid nodule were higher(P < 0.05).(5)After adjusting for age,course of disease,waist circumference,BMI,smoking history,drinking history,HbA1 c,TG,TC,TPOAb,thyroid nodule,DN,DR and CAS,logistic regression analysis showed that age,TPOAb positive,thyroid nodules,DN and CAS were the main influencing factors of T2 DM combined with hypothyroidism.Low TC,positive TPOAb,thyroid nodules and DN were the main influencing factors for T2 DM combined with hyperthyroidism.Conclusion:(1)T2DM combined with TD is clinically common,among which the prevalence of combined hypothyroidism is the highest,especially the proportion of combined subclinical hypothyroidism is the largest.(2)T2DM patients with TD were older and had a longer course of disease.HbA1 c decreased in patients with combined hypothyroidism,aging and CAS were more prominent.The patients with hyperthyroidism were more emaciated and had lower blood lipid.(3)TPOAb positive,thyroid nodules and DN were common influcing factors for T2 DM combined with TD.