The Comparative Study On The Influence Of Subclinical Hypothyroidism On The Incidence Of Chronic Complications In Patients With Type 2 Diabetes Mellitus

Objective:To investigate the effects of subclinical hypothyroidism on the incidence of chronic complicati-ons in patients with type 2 diabetes mellitus.Method:A part of patients with type 2 diabetes mellitus who were admitted to the Department of Endocrinology from November 2018 to December 2019 were selected.According to whether or not with the subclinical hypothyroidism,100 cases were classified into subclinical hypothyroidism group,100 cases were classified into Normal thyroid function group.The clinical data and the incidence of chronic complications were compared between the two groups.Result:(1)Men accounted for 44% in The subclinical hypothyroidism group and accounted for 62% in the Normal thyroid function group.The gender ratio of the two groups was significantly different(44% vs 62%,P<0.05).(2)In the subclinical hypothyroidism group,the level of TSH(7.65±7.89)uIU/m、TGAb(157.12±523.31)IU/ml、TPOAb(62.09±124.01)IU/ml、TC(4.84±1.01)mmol/l,which were significantly higher than those in Normal thyroid function group(2.19±0.97)uIU/ml、(29.97±93.87)IU/ml、(16.19±33.21)IU/ml、(4.43±1.34)mmol/l(P<0.01 or P<0.05)。The level of FT4 and HDL-C in the subclinical hypothyroidism group were(1.12±0.37)mmol/L and(1.09±0.26)mmol/l which was significantly lower than those in Normal thyroid function group(16.35±2.56 pmmol/l 、1.19±0.27mmol/l)(P<0.01 and p<0.05).(3)The severely abnormal urine microalbumin-to-urine creatinine ratio(UACR>33.9)in the hypothyroidism group was 18% while was 2% in Normal thyroid function group(P<0.01),but there was no significant difference in the rates ofdiabetic retinopathy 、 mildly abnormal urine microalbumin-to-urine creatinine ratio(3.4<UACR≤33.9)between the two groups(P>0.05).(4)there was no significant difference in the rate of Sensory neuropathy on foot(P>0.05).The diabetic peripheral neuropathy in the hypothyroidism group was66% while was 49% in Normal thyroid function group(P<0.05).(5)In the subclinical hypothyroidism group,The incidence of level 2 peripheral arteriosclerosis was significantly lower than that in Normal thyroid function group(20% vs 34%,P<0.05),while the incidence of level 3 peripheral arteriosclerosis was significantly higher than that in Normal thyroid function group(73% vs58%,P<0.05).And the incidence of lower extremity arteriosclerosis in the subclinical hypothyroidism group was significantly higher than that in Normal thyroid function group(30% vs 15%,P<0.05).Conclusion:The majority of type 2 diabetes patients with subclinical hypothyroidism were female.Subclinical hypothyroidism has adverse effects on blood lipids in patients with T2 DM.And it will also increase the incidence of diabetic peripheral neuropathy、diabetic lower extremity arterial disease,It also increases the incidence of highly abnormal urinary uACR and carotid plaque formation.