| Objective:The aim of this study was to explore the association between serum thyroid stimulating hormone（TSH）and blood lipid in patients with type 2 diabetes mellitus.Blood lipids include the following ones:Total cholesterol（TC）,Triglyceride（TG）,high density lipoprotein-cholesterol,Low density lipoprotein-cholesterol（LDL-C）.Methods:There were 903 patients included in our study.And they were all diagnosed type 2 diabetes from Department of Endocrinology,Affiliated Hospital of Jining Medical University,they were hospitalized in this hospital from June 1,2017 to July 31,2019.General clinical data were collected through the electronic medical record system,including the following ones,such as the basic information of these patients,whether they had T2DM family history or not,chronic disease histories,DM complications,DM course,whether lipid-lowering medications were used or not,and so on.The biochemical indexes included the following ones:Fasting plasma glucose（FPG）,TSH,Free thyroxine 3（FT3）,Free thyroxine 4（FT4）,and Glycosylated Hemoglobin（HbAlc）,liver and kidney function,lipid indices,and so on,and Waist circumference（WC）and Hip circumference（HC）in the patients were measured and Body mass index（BMI）,Waist hip rate（WHR）,Homeostasis Model assessment of Insulin Resistance（HOMA-IR）were caculated.We used Empower（R）software to statistically analyze.Results:（1）The level of serum TSH in women with T2DM was significantly higher than that in men.The levels of serum TC and HDL-C in females were higher than those in males,while the levels of serum TG and LDL-C were lower than those in males（P<0.05）.（2）Univariate analysis of serum lipid and TSH in different genders of T2DM patients showed that serum TSH was significantly positively correlated with TC and LDL-C in female patients（P<0.05）.There was no significant correlation between TSH and TG,TC,HDL-C and LDL-C in male patients.（3）After adjusting the correlation and confounding factors,smooth curve fitting and multivariate regression analysis showed that there was an inflection point and non-linear relationship between serum TSH and TG in female T2DM patients.When TSH<2.93mIU/L,between TSH and TG there was a positive correlation,also the difference was statistically significant（β 0.20,95%CI0.07,0.34;P=0.004）;There was a positive linear and independent correlation between serum TSH and LDL-C（β0.08,95%CI 0.02 0.13;P=0.006）.There was no significant correlation between blood TSH and TG,HDL-C.In the same way,there was no significant correlation between TSH and TG,TC,HDL-C and LDL-C in the male patients.Conclusions:In our study,it was showed that serum TSH level is correlated with blood lipid in T2DM patients,and the association had gender difference.In the female T2DM patients,there was a linear positive correlation between serum TSH level and LDL-C,and there was a non-linear relationship between serum TSH level and TC.When the serum TSH level was less than 2.93mIU/L,there was a positive correlation with TC,and there was no significant correlation between serum TSH and TG,HDL-C.In male T2DM patients,there was no significant correlation between serum TSH and TG,TC,HDL-C and LDL-C.In clinical practice,emphasis should be placed on the evaluation of dyslipidemia in T2DM patients with elevated TSH levels,especially in female patients with T2DM. |
