| Objective: To compare the clinical characteristics and islet function between type 2 diabetes mellitus(T2DM)patients and T2 DM patients combined with Hashimoto’s thyroiditis(HT).In addition,to explore the influence of Hashimoto thyroiditis on islet function of T2 DM patients and the clinical characteristics of T2 DM patients with different thyroid function.Methods: A retrospective case-control study was conducted to select 396 T2 DM patients who were hospitalized in the Department of Endocrine Metabolism,the Second Hospital of Lanzhou University from October 2017 to March 2019,including 142 patients with HT.Tendency value matching method was used to match the age,the course of diabetes,the time of previous insulin use and body mass index.222 cases of simple T2 DM group and 111 cases of T2 DM with HT group were selected by 2:1,and the difference of clinical characteristics between the two groups was compared;T2DM combined with HT group was divided into three groups according to the antibody positive condition: thyroid globulin(TG)single antibody positive group,thyroid peroxidase(TPO)single antibody positive group and TG and TPO double antibody positive group,in order to compare the clinical characteristics of T2 DM patients with different thyroid autoantibodies;the independent risk factors of HT in T2 DM patients were evaluated by multivariate logistic regression analysis.According to the thyroid function,all the selected patients were divided into normal thyroid function group(299 cases),subclinical hypothyroidism group(25 cases)and clinical hypothyroidism group(9 cases).The influence of thyroid function on the clinical indicators of T2 DM patients was compared through statistical analysis of patients’ clinical data.Result:1.The proportion of female patients in T2 DM and HT group was significantly higher than that in T2 DM group(P < 0.05).The BMI,serum uric acid and C-peptide level of T2 DM with HT group were significantly lower than those of T2 DM group(P < 0.05).Compared with T2 DM group,the daily insulin requirement of T2 DM combined with HT group increased significantly(P < 0.05).2.Compared with T2 DM group,T2 DM combined with HT group was more likely to have diabetic macroangiopathy and the difference was statistically significant(P < 0.05).Compared with T2 DM group,TG single antibody positive group and TG,TPO double antibody positive group were more likely to have diabetic macrovascular complications,the difference was statistically significant(P < 0.05).3.Gender was the main independent risk factor for T2 DM patients with HT(r = 4.294,95% CI: 2.547-7.240,P = 0.000).BMI was negatively correlated with the incidence of HT in T2DM(r = 0.900,95% CI: 0.817-0.991,P = 0.033).4.The proportion of female patients and the systolic pressure in subclinical hypothyroidism group was higher than that in normal thyroid function group,the difference was statistically significant(P < 0.05).Conclusion:compared with T2 DM patients,T2 DM patients combined with HT have poorer islet function and are prone to macrovascular complications.Gender is the main independent risk factor for T2 DM patients with HT.T2 DM patients with subclinical hypothyroidism have higher systolic blood pressure than T2 DM patients with normal thyroid function. |
