The Correlation Study Between 25 Hydroxyvitamin D And Other Metabolic Factors And Elderly Type 2 Diabetes Patients With Hashimoto’s Thyroiditis

Objective:To understand the distribution characteristics of Hashimoto’s thyroiditis in elderly patients with type 2 diabetes and its correlation with vitamin D and other factors,and to further understand the role of vitamin D in Hashimoto’s thyroiditis,so as to provide new ideas for the treatment of autoimmune thyroiditis.Methods:A total of 700 elderly diabetic patients over 60 years old who were admitted to the Department of Endocrinology of Affiliated Hospital of Qingdao University from July,2015 to December,2019 were enrolled,and another 300 elderly non-diabetic subjects who underwent physical examination were selected as the control group according to the principle of matching age and body mass index.TPOAb,TGAb,TSH,FT4,FT3 were measured by electrochemiluminescence immunoassay.According to the diagnostic criteria of Hashimoto’s thyroiditis,The population is divided into Hashimoto’s thyroiditis and non-Hashimoto’s patients.BMI,Hb A1c,fasting blood glucose,insulin level,vitamin D,serum calcium,phosphorus,high density lipoprotein,low density lipoprotein,triglyceride,cholesterol and other indicators were collected for statistical analysis,SPSS25.0 software was used for statistical analysis.Continuous data were described by median±quartile range and compared by Mann-Whitney U test,dichotomous data byχ~2test.The correlation analysis between Hashimoto’s thyroiditis and other indicators was processed by Spearman correlation,and binary logistic regression analysis was used for analysis of influencing factors.Results:In our study,Vitamin D3 deficiency is common in elderly people,and the prevalence of autoimmune thyroiditis and vitamin D deficiency in elderly type 2 diabetes patients is higher than that in normal population(P<0.05).In elderly type 2 diabetes patients,female patients are more likely to suffer from Hashimoto’s thyroiditis.The vitamin D level of Hashimoto thyroiditis group was lower than that of non-Hashimoto thyroiditis patients,but the low density lipoprotein level,total cholesterol level and fasting insulin level were higher than that of non-Hashimoto thyroiditis patients,and the differences were statistically significant(P<0.05).Spearman correlation analysis indicated that there no apparent correlation between TPOAb,TGAb and vitamin D,But there was positive correlation between TPOAb and triglyceride,low density lipoprotein,so was TGAb and total cholesterol,low density lipoprotein.There was negative correlation between TSH and 25(OH)D3,positive correlation between TSH and serum lipid.There was positive correlation between FT3,FT4 and 25(OH)D3,negative correlation between FT4 and serum lipid.Binary logistic regression analysis suggested that gender,25(OH)D3,total cholesterol and low density lipoprotein were riskfactors of Hashimoto’s thyroiditis in elderly patients with type 2 diabetes.Conclusions:Elderly patients with type 2 diabetes iseasy to combine with Hashimoto thyroiditis and vitamin D deficiency.Female,25(OH)D3,total cholesterol and low density lipoprotein were risk factors of Hashimoto’s thyroiditis in elderly patients with type 2 diabetes.Serum lipid was linearly related to the level of TPOAb,TGAb,TSH and FT4.25(OH)D3 was linearly related to thyroid function,but there was no obvious linear relationship between 25(OH)D3 and TPOAb,TGAb.Our research provided a clinical basis for further prevention and management of the elderly type 2 diabetes mellitus with Hashimoto’s thyroiditis.