Correlation Between Insulin Resistance And Thyroid Functions In Patients Undergoing Gastric Or Colorectal Tumor Surgery

Objective:To investigate the relationship between insulin resistance(IR)and thyroid functions in patients undergoing gastric or colorectal tumor surgery.Methods:We collect and record the clinical data of the patients who were hospitalized in the Eastern District of Shandong Provincial Hospital from February 2019 to January 2021,undergoing gastric or colorectal tumor surgery.The data includes gender,age,BMI index,operation site,operation method,operation time,postoperative hospitalization days,and the patients’ fasting blood glucose(FBG),fasting insulin(FINS),and serum thyroid-related hormones(FT3,FT4,TSH),C-reactive protein(CRP)and procalcitonin(PCT)levels before operation and the 1st,3rd,5th days after operation,and calculate the insulin resistance index HOMA-IR(FINS × FBG/22.5),analyze their variation trends and correlations with each other,and use multiple linear regression to evaluate the independent influencing factors of HOMA-IR and fasting blood glucose.Outcomes:There was a significant negative correlation between fasting blood glucose and serum FT3 levels on the 3rd and 5th days after surgery(r=-0.228,P<0.01;r=-0.254,P<0.01);there was no significant correlation(P>0.05)between FT4 levels and fasting blood glucose serum before and after surgery.Fasting blood glucose and serum TSH levels on the 1st,3rd and 5th days after surgery were significantly negatively correlated(r=-0.191,P<0.01;r=-0.324,P<0.01;r=-0.266,P<0.01).There was a significant positive correlation between fasting blood glucose and serum CRP levels on the 3rd and 5th day after operation(r=0.219,P<0.01;r=0.285,P<0.01);the fasting blood glucose and serum PCT level on the 3rd day after operation showed a significant positive correlation(r=0.239,P<0.01).After multiple linear regression analysis,serum TSH concentration on the 3rd day after operation was an independent influencing factor of fasting blood glucose.There was a positive correlation between HOMA-IR and serum FT3 levels before surgery and on the 1st,3rd,and 5th day after surgery(r=0.263,P<0.01;r=0.135,P<0.05;r=0.114,P<0.05;r=0.258,P<0.01);while there was no correlation between HOMA-IR and FT4,TSH,CRP,PCT before and after operation(P>0.05).The fasting blood glucose on the 1st,3rd,and 5th day after operation was positively correlated with the patients’ age(r=0.129,P<0.05;r=0,136,P<0.05;r=0.218,P<0.01);on the 1st day after operation,the fasting blood glucose was significantly positively correlated with the length of surgery(r=0.216,P<0.01).At the same time,the fasting blood glucose on the 1st day after surgery was also related to the surgical site.The fasting blood glucose on the 1st day after surgery in patients with gastric cancer was significantly higher than that of the colorectal cancer patients(P<0.05);in addition,the fasting blood glucose on the 3rd and 5th day after operation was also positively correlated with the patients’ BMI index(r=0.204,P<0.01;r=0.184,P<0.05).However,there was no correlation between the patients’ gender,operation method and perioperative blood glucose level(P>0.05).The HOMA-IR index on the 3rd day after surgery was negatively correlated with the patients’ age(r=-0.113,P<0.05),and the HOMA-IR on the 3rd day after surgery was also related to the surgical site and operation method(P<0.05).The HOMA-IR before operation and on the 1st,3rd and 5th day after operation were significantly positively correlated with the patients’ BMI index(r=0.555,P<0.01;r=0.379,P<0.01;r=0.464,P<0.01;r=0.401,P<0.01).Conclusion:Patients will develop insulin resistance after gastric or colorectal tumor surgery,as well as an impaired thyroid function,which is manifested by a decrease in serum FT3 and TSH levels,and an increase in FT4 levels.Postoperative IR may be related to the impaired thyroid function and the body’s inflammatory response,and the serum TSH level is an independent influencing factor of the patient’s third postoperative abdominal blood glucose.In addition,postoperative IR may also be related to the patients’ age,surgical site,surgical method,and patients’BMI index.