| Type 2 Diabetes Mellitus(T2DM)is a common endocrine and metabolic disease.At present,the number of diabetes patients in China has surpassed that in India,ranking first in the world.It is estimated that the number of diabetes patients in China will reach 120 million by 2045.There is no cure for T2 DM,and with the extension of the course of disease,many complications often accompany it,causing multiple organ dysfunction and even failure,leading to premature death,which seriously threatens human health.Thyroid Dysfunction(TD)is the second most common endocrine disease.Some studies show that the prevalence rate of TD in diabetic patients is 2-3 times that of the general population.Because of the common immune mechanism,this phenomenon is more common in patients with type 1 diabetes.However,more and more studies show that patients with T2 DM are often complicated with TD,and the most common form of TD is subclinical hypothyroidism(SCH).T2 DM complicated with TD often affects the progression of T2 DM and increases the risk of cardiovascular complications in diabetic patients.At present,studies in both China and abroad have different reports on the incidence of T2 DM patients complicated with TD,and have different opinions on whether early screening and intervention are necessary for T2 DM patients complicated with TD.Therefore,this study aims to understand the prevalence of T2 DM complicated with TD and explore the influencing factors of T2 DM complicated with TD,on the task in better controling the blood sugar level in clinic.Objective:This study analyzes the clinical data of T2 DM patients in hospital,analyzes the related influencing factors of T2 DM patients complicated with TD,and discusses the clinical characteristics of T2 DM patients complicated with TD.The task is designed to carry out screening and intervention as early as possible.Methods:430 T2 DM patients hospitalized in endocrinology department of our hospital from September 2018 to December 2019 were collected,and their basic information,including name,age,gender,body mass index(BMI),course of diabetes,number of diabetic complications,whether taking metformin was collected.Laboratory indexes of patients recorded include fasting blood glucose(FBG),fasting C peptide(FCP),glycosylated hemoglobin(Hb A1c),thyroid function five items(free triiodothyronine(FT3),free thyroxine(FT4),thyroglobulin antibody(TGAb),thyroid stimulating hormone(TSH),thyroid peroxidase antibody(TPOAb)),blood lipid four items(total cholesterol(TC),Low density lipoprotein(LDL),high density lipoprotein(HDL),triglyceride(TG)),microalbuminuria(UM),Serum uric acid(SUA).All data were analyzed by SPSS26.0 statistical software.Statistical methods were used to describe the basic situation of the study subjects.the data of measurement data were expressed by mean or median plus standard deviation,and the data of measurement data were expressed by percentage.T-test,chi-square test and Logistic regression analysis were used to carry out statistical processing on the data,P<0.05 was expressed as statistically significant.Results:1.A total of 430 T2 DM patients,245 males(57%)and 185 females(43%),were enrolled.324 cases of T2 DM with normal thyroid function,aged(60.22±12.07)years;A total of 106 patients with T2 DM complicated with thyroid dysfunction,aged(61.54±11.90)years,including 47 subclinical hypothyroidism,28 low T3 syndrome,12 clinical hyperthyroidism,10 clinical hypothyroidism and 9 subclinical hyperthyroidism.In all T2 DM patients,78 cases were positive for thyroid autoantibodies and 352 cases were negative for thyroid autoantibodies.2.According to thyroid function,430 T2 DM patients were divided into the normal thyroid function group and the subclinical hypothyroidism group.Data analysis of the two groups showed that FBG,TC,LDL,TPOAb and FCP were significantly increased in the subclinical hypothyroidism group compared with the normal thyroid function group,and the differences were statistically significant(P < 0.05);3.Compared with the group w/o metformin,the TSH level of the group with metformin was significantly decreased(p < 0.05).4.Logistic regression analysis indicated that female,fasting blood glucose,serum uric acid and low density lipoprotein was positively correlated with thyroid dysfunction in patients with T2 DM..Conclusion:1.T2 DM complicated with thyroid dysfunction often occurs in clinic,with subclinical hypothyroidism accounting for 10.93%.2.FBG,TC,LDL,FCP and TPO antibodies in T2 DM patients with subclinical hypothyroidism were significantly higher than those with normal thyroid function.3.Metformin can reduce the level of TSH and then affect thyroid function,indicating that metformin may affect the level of TSH by affecting the activity of adenylate-activated protein kinase(AMPK).4.Female,fasting blood glucose,serum uric acid,low density lipoprotein was risk factors for T2 DM patients with thyroid dysfunction. |
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