Relationship Between Subclinical Hypothyroidism And Peripheral Blood Three Line Cells In Patients With Type 2 Diabetes Mellitus

Objectives:In recent years,subclinical hypothyroidism has been found to be associated with type 2 diabetes and is associated with peripheral blood trisomy cell abnormalities.By comparing the blood cell analysis of type 2 diabetes patients with normal thyroid function and subclinical hypothyroidism,this study discusses the correlation between subclinical hypothyroidism and peripheral blood trisomy cell abnormalities in type 2 diabetes patients,and provides the basis for early screening and intervention of subclinical hypothyroidism in clinical practice.Methods:The patients with type 2 diabetes who were hospitalized in the Department of Endocrinology,the Second Affiliated Hospital of Kunming Medical University from January 2019 to December 2020 and had thyroid function,blood cell analysis and biochemical tests on the same day were selected.All their medical records were consulted.The data of the same item detected by the same patient on different dates were excluded,and only the data of the first visit were collected.According to the inclusion,exclusion and related diagnostic criteria of the study,a total of 488 subjects were selected and analyzed retrospectively.The admission data,Thyroid function and antibodies,blood cell analysis,blood lipid and blood glucose were recorded.The subjects were divided into two groups according to whether they were combined with subclinical hypothyroidism at the same time:non subclinical hypothyroidism group(NSCH group,n=248)and subclinical hypothyroidism group(SCH group,n=240).After sorting out the data,SPSS(25.0)was used for statistical analysis to compare the differences and correlations between the two groups.Results:1.Basic data:the difference between the two groups was not statistically significant(P>0.05);2.Thyroid function and antibodies index:the difference of TSH、T3、TPOAb、TGAb between the two groups was statistically significant(P<0.05),the values in SCH group were higher than those in NSCH group,the FT4 was lower than NSCH group,differences were statistically significant(P<0.05);3.Blood cell analysis:the L、L%、PLT、MPV、PCT、PDW difference between the two groups was statistically significant(P<0.05),the values in SCH group were higher than those in NSCH group,the GR、GR%、RBC、HGB、MCH in SCH group was lower than NSCH group,the difference was statistically significant.4.Glycolipid metabolism index:the TC、LDL-C and HDL-C in SCH group were significantly higher than those in the NSCH group,and TG、FPG down,all the differences were statistically significant(P<0.05).5.The correlation between peripheral blood triacycles and thyroid function in SCH group:SCH group WBC was positively correlated with FT3,r=0.144(P<0.05);L is positively correlated with FT3,r=0.135(P<0.05);HGB is negatively correlated with TSH,r=-0.223(P<0.05),positively correlated with FT3,r=0.165(P<0.05);HCT is positively correlated with T3、FT3,r=:0.204,0.314(P<0.05);MCV is negatively correlated with FT4,r=-0.18(P<0.05);MCHC is negatively correlated with TGAb、TPOAb,r=-0.223、-0.156(P<0.05);PLT is positively correlated with TSH,r 0.137(P<0.05),A negative correlation with FT3、T4,r were-0.164 and-0.19(P<0.05);MPV is positively correlated with TSH,r=0.168(P<0.05),A negative correlation with T4,r=-0.164(P<0.05).The prevalence of anemia in SCH group(17.5%)was significantly higher than that in NSCH group(5.24%),differences were statistically significant(P<0.05),the results of regression analysis showed that TSH was a very important risk factor T2DM anemia in combined SCH.Make TSH ROC curves,And calculate the area under the curve,the area under the TSH curve:AUC=0.729,P<0.001,the sensitivity was 73.8%,the specificity was 90.75%,the Jordan index is 0.65,the Critical value was 7.29.The area under curve of male patient TSH in SCH group:AUC=0.698,P<0.05,the critical value was 7.29,female patient TSH area under curve:0.758,P<0.001,the critical value was 7.09.Conclusions:1.The absolute value and percentage of neu troph ils were significantly lower than the normal group,and lymph were significantly higher than those of the T2DM group,but the difference in the white blood cell number was not obvious.2.The RBC、HGB、MCH of T2DM group with SCH was significantly lower than that of normal group.The incidence of anemia was 17.5.and the HGB was negatively correlated with TSH.The optimal critical value of TSH was 7.29,which can be used as an effective predictor of anemia in patients with combined anemia.3.The PLT、MPV、PCT、PDW of T2DM group with SCH was significantly higher than that of normal group,attention should be paid to the risk of cardiovascular disease in such patients.