Study On The Relationship Between Thyroid Function Changes And Vascular Complications In Type 2 Diabetes

Objective To study the changes of thyroid hormone levels in patients with type 2 diabetes,and to explore the relationship between thyroid hormone levels and complications and severity in patients with type2 diabetes.Understand the significance of screening for nail function in patients with type 2 diabetes in order to guide clinical work.Methods A retrospective case study method was used to collect type 2 diabetes patients admitted to the First Affiliated Hospital of Chongqing Medical University from January 2013 to September 2019 as the case group(T2DM group),and the healthy physical examination population was the normal control group(NC group).In addition,the T2 DM group was divided into three subgroups according to the relevant standards,namely,the diabetic avascular complications group(T0 group,n= 85),the diabetic microvascular complications group(T1 group,n = 89),and the diabetic macrovascular complications group(T2 group,n = 85),then diabetic microvascular complications group was divided into mild group(T1a group,n = 41)and severe group(T1b group,n = 48)accordingto the severity of the disease.Record age,gender,course of disease,urine microalbumin / creatinine ratio,blood creatinine,estimated glomerular filtration rate,thyroid function indicators(FT3,FT4,T3,T4,uTSH),and compare the differences of the indicators in each group.At the same time,the correlation between thyroid function indexes and other indexes of type2 diabetes patients was analyzed.Results 1.FT3 and T3 in the T2 DM group were significantly lower than those in the NC group,and FT4 was significantly higher than that in the NC group.The differences were statistically significant(P = 0.000);however,there was no statistical difference between the T4 DM group and the NC group in T4 and uTSH.Significance(P> 0.05).2.The FT3 of the NC group was significantly higher than that of the T0 group,T1 group,and T2 group(P were 0.006,0.000,and 0.000,respectively).The FT3 of the T1 group was significantly lower than that of the T0 group(P = 0.003),T0 group and T2 There was no statistical difference between the group,T1 group and T2 group.FT4 in T0 group was slightly higher than that in NC group(P = 0.039),FT4 in T2 group was significantly higher than that in NC group(P = 0.000),NC group and T1 group,T0 group and T1 group,T0 group and T2 group,There was no statistical difference between T1 group and T2 group.T3 in NC group was significantly higher than that in T0 group,T1 group,and T2 group(P were 0.000,0.000,and 0.001,respectively).There were no statistics between T0 group and T1 group,T0 group and T2 group,T1 group and T2 group difference.The uTSH of T1 group was slightly higher than that of T0 group(P = 0.023),and there was no statistical difference between NC group and T0 group,NC group and T1 group,NC group and T2 group,T0 group and T2 group,T1 group and T2 group.There was no statistical difference in T4 comparison between groups.3.The FT3 of NC group is significantly higher than that of T0 group and T1 b group(p = 0.007,0.000),and slightly higher than that of T1 a group(p = 0.024).The FT3 of T1 b group is more obvious than that of T0 group and T1 a group.Decreased(p = 0.000,0.001),there was no statistical difference in FT3 between T0 group and T1 a group.FT4 in T0 group was slightly higher than that in NC group(p = 0.035),and there was no statistical difference between NC group and T1 a group,NC group and T1 b group,T0 group and T1 a group,T0 group and T1 b group,T1 a group and T1 b group.Compared with T0 group,T1 a group and T1 b group,T3 in NC group was significantly higher(p = 0.000,0.000,0.000),T3 in T1 b group was slightly lower than that in T0 group(p = 0.025),T0 group and T1 a group,T1 a There was no statistical difference between the group and the T1 b group.There was no statistical difference between T4 and uTSH in each group.4.Pearson correlation analysis showed that FT3 was significantly negatively correlated with blood creatinine and urine microalbumin / creatinine ratio;it was significantly positively correlated with estimated glomerular filtration rate.T3 was significantly negativelycorrelated with serum creatinine;negatively correlated with urine microalbumin / creatinine ratio;and significantly positively correlated with estimated glomerular filtration rate.uTSH was significantly positively correlated with urine microalbumin / creatinine ratio;it was significantly negatively correlated with estimated glomerular filtration rate.There was no significant correlation between FT4,T4 and serum creatinine,urine microalbumin / creatinine ratio,and estimated glomerular filtration rate(p>0.05).Conclusion There are changes in thyroid hormone levels in patients with type 2 diabetes,and changes in thyroid-related index values are more easily observed in patients with diabetes and microvascular complications,and changes in thyroid-related indexes can reflect the severity of type 2diabetes patients to a certain extent.Therefore,in clinical work,it is necessary to pay more attention to the detection of thyroid hormone in patients with type 2 diabetes,and the level of thyroid hormone is of great significance for the evaluation of T2 DM patients' condition and prognosis.Early detection of abnormal thyroid function in patients with T2 DM can not only better control the condition,but also prevent the occurrence and development of complications.