| Objective: To study the relationship between adiponectin level and type 2diabetes with hypothyroidism and coronary heart disease related factors,and further explore the correlation between adiponectin and disease development.Method: From July 2016 to October 2018,the diabetic patients admitted to the Xihua County People’s Hospital were selected as the research object.240 eligible patients were selected and divided into three groups according to the differences of the patients’ combined diseases.80 cases of type 2 diabetes were taken as group B,80 cases of type 2 diabetes with hypothyroidism without coronary heart disease were taken as group C,80 cases of type 2 diabetes with hypothyroidism and coronary heart disease were taken as group D,and symptomatic treatment was given to three groups.In addition,80 cases of health check-ups in the same period were selected as group A.Serum adiponectin levels and related biochemical indicators were measured before and after treatment,and blood CRP and TNF-α m RNA expression levels were detected by RT-PCR.Results: Before treatment,the serum adiponectin levels in group A were significantly higher than those in the other three groups(P<0.01),and the serum adiponectin levels in group D were lower than those in the other three groups(P<0.05).After treatment,the serum adiponectin levels of patients in groups B,C,and D improved,showing an upward trend.There was no significant difference in serum adiponectin indicators in patients of groups B,C,and D(P>0.05).The insulin resistance index was the highest in the group,which was significantly higher than the other groups(P<0.01).The differences in the decrease of the insulin resistance index between group D and patients B and C were statistically significant(P<0.05).Compared with the normal group,the difference was significant.It was statistically significant(P<0.05).After treatment,there was no significant difference in insulin resistance index between groups B,C,and D(P>0.05),but it was still higher than that of group A(P<0.05).Compared with group A,the levels of high-sensitivity C-reactive protein(CRP)and tumor necrosis factor α(TNF-α)in groups B,C,and D were significantly increased(P<0.01).Compared with group B,C,D The levels of the two factors in the two groups were significantly decreased(P<0.05).Before treatment,compared with A and B,the TSH levels in the C and D groups were significantly increased(P<0.05,P<0.01),and FT3 levels were significantly reduced(P<0.05,P<0.01),and the two factor levels were also significantly increased in groups D and C(P<0.05).After treatment,CRP and TNF-α levels in the three groups decreased,The difference between the two comparisons is not significant(P>0.05),But still lower than the level of group A.After treatment,the FT3 index in group D is significantly lower than the other three groups(P<0.05).The TSH index of group D patients is significantly higher than those in group A and B(P<0.05).There was no significant difference in TSH index in group B(P>0.05),and there was no significant difference in FT4 index among the four groups(P>0.05).Before treatment,A group fasting blood sugar level was significantly lower than the other three groups(P<0.05),there was no significant difference among the other three groups(P>0.05).Before and after treament,four groups of serum cholesterol,low-density lipoprotein levels was not significantly different(P>0.05),before treatment,the level of triglyceride in group C and D was higher than that in group A(P<0.05),there was no significant difference in triglyceride levels between the four groups after treatment(P>0.05),before treament A group of patients with high-density lipoprotein was significantly higher than other indexes three groups(P<0.01),group B,group C and group D HDL levels had no significant difference(P>0.05).Before treatment,the expression of CPR and TNF-α in group A was significantly lower than that in other three groups(P<0.05).The specific expression levels of CPR and TNF-α in group C and group D were significantly higher than those in group B(P<0.05).After treatment,the expression of CPR and TNF-α in group A was significantly lower than that in group B(P<0.05).The expression levels of CRP and TNF-α in the three groups were all decreased,and there was no significant difference between the three groups(P>0.05),but it was still higher than that in the group A(P<0.05).Accompanied by arteriosclerosis,serum adiponectin levels were significantly increased(P<0.05),Serum adiponectin levels were significantly increased in patients with arteriosclerosis(P<0.05).Multiple linear regression showed that serum adiponectin was negatively correlated with TC,TG,LDL,CRP,TNF-α and HOMA-IR,and positively correlated with HDL and FT3.Conclusion:1.With the development of the course of type 2 diabetes,the level of adiponectin decreases significantly when combined with hypothyroidism,and the decline of adiponectin is more significant when there is coronary heart disease on the basis of combined hypothyroidism;2.The level of adiponectin is negatively correlated with LDL,TG,FBG,insulin resistance,TSH,and coronary heart disease risk factors CRP and TNF-α,and positively correlated with HDL and FT3;3.Adiponectin can be used as a protective factor of coronary heart disease to monitor the occurrence and development of coronary heart disease. |
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