Relationship between blood glucose parameters and experimental items of thyroid in patients with type 2 diabetes / 中国综合临床

Objective To study the relationship between thyroid function and disease severity or insulin resistance in patients with type 2 diabetes.Methods A total of 500 patients with type 2 diabetes and 60 normal controls were enrolled in our study.Fasting blood free three iodine thyroid original thyroid hormones(FT3) and free amino acid(FT4),thyroid stimulating hormone(TSH),thyroid related antibodies(thyroid peroxidase antibody(TPOAb) and thyroglobulin antibody(TGAb)) of two groups of selected objects were detected.In patients with type 2 diabetes group,blood insulin,glycated hemoglobin(HbA1c),and the determination of trace albumin urine creatinine(UCr) and (UMA) were assayed.Results FT3 and TSH of control group was (4.14±1.52) pmol/L,(2.10±1.33) mIU/L,but the level of case group was (4.53±0.72) pmol/L,(1.78±0.97) mIU/L respectively,the difference between case group and control group of serum FT3 and TSH were statistically significant(P=0.03,0.025).The serum FT3 significantly decreased in patients with high blood sugar,the difference between HbA1C>11% group(FT3=(3.76±0.78) pmol/l) and HbA1C≤7%(FT3=(4.37±0.78) pmol/l),7-9%(FT3=(4.24±0.62) pmol/l),9-11% (FT3=(4.36±1.68) pmol/l) groups were statistically significant(P=0.014,0.009,0.000).The higher urine MA/Cr,the more serum FT3 decreased,the difference between urine MA/Cr<30 mg/g group(FT3=(4.31±0.18) pmol/l) and 30 mg/g≤MA/Cr<300 mg/g(FT3=(4.00±0.79) pmol/l),MA/Cr≥300 mg/g (FT3=(3.50±0.76) pmol/l) groups were statistically significant(P=0.041,0.001).The differences between MA/Cr≥300 mg/g group and 30 mg/g≤MA/Cr<300 mg/g group was statistically significant(P=0.044).In addition,we found a correlation between serum TSH and insulin resistance index(HOMA-IR)(r=0.302,P=0.001).Conclusion As a sign of serious high blood sugar,it can predict the severity of diabetic nephropathy.There is intimate relationship of serum TSH and HOMA-IR.

Analysis of risk factors of diabetic foot / 中国综合临床

Objective To evaluate the risk factors for diabetic foot in patients with type 2 diabetic mellitus (T2DM).Methods One hundred and forty-three patients with T2DM including 63 cases with diabetic foot(DF) and 80 cases with non-diabetic foot (NDF) were recruited.All possible risk factors for diabetic foot were documented,including low density lipoprotein-cholesterol (LDL-C),homocysteine (Hcy),diabetic polyneuropathy(DPN),diabetic retinopathy(DR),peripheral vascular disease(PVD) and so on.Results (1) There were significant differences between DF group and NDF group in terms of general clinical data,including age(65.38±11.58) years old and (60.12±9.92) years old,precious history of foot ulcer(28.6％ (18/63) and 3.8％(3/80)),serum homocysteine(Hcy) ((23.24± 11.77) μmol/L and (18.62±7.74) μmol/L)),glycosylated hemoglobin(HbA1c) ((10.22±2.81) ％ and (8.67±2.30) ％),blood albumin (Alb) ((32.45±5.83) g/L and (38.58±4.71) g/L),LDL-C ((2.15±0.72) mmol/L and (2.60±0.78) mmol/L),diabetic nephropathy (DN) (77.8％ (49/63) and 45.0％ (36/80)),diabetic retinopathy (DR) ((73.0％ (46/63) and 33.8％ (27/80)),diabetic peripheral vascular disease (PVD) (93.7％ (59/63) and 65.0％ (52/80)) and diabetic peripheral neuropathy (DPN) (77.8％ (46/63) and 60.0％ (48/80)) (P ＜0.05).(2) Logistic regression analysis showed that the development of diabetic foot was significantly correlated with age(OR =1.09,95％ CI:1.02-1.16,P =0.01),Hcy (OR =1.12,95％ CI:1.03-1.22,P =0.01),DR(OR=8.47,95％CI:1.85-38.87,P=0.01),PVD(OR=8.73,95％CI:1.07-70.92,P =0.04) and precious history of foot ulcer (OR =12.28,95％ CI:1.57-96.28,P =0.02).Conclusion Complications due to multiple factors of Diabetic foot,and Hcy is another risk factor for that.

Change of serum 25-(OH)D3 levels in patients with different subtypes of autoimmune thyroid diseases / 中国综合临床

Objective To investigate the relationship between serum 25-(OH) D3 and autoimmune thyroid diseases (AITD).Methods Serum levels of 25-(OH) D3, thyroid antibodies (thyroid stimulating hormone receptor antibody (TRAb), TGAb (thyroid globulin antibody), thyroid peroxidase antibody (TPOAb) and thyroid function of 32 cases patients with Graves' diseases (GD), 17 cases patients without remission of GD,10 cases patients with remission of GD,35 cases patients with Hashimoto's thyroiditis (HT),and 58 cases healthy subjects were measured,and the relationships between serum 25-(OH) D3 and the above clinical index were analyzed.Results The serum level of 25-(OH) D3 in patients with GD or HT were obviously lower than that in healthy subjects((50.75±17.60) μg/L, (36.40±21.65) μg/L, (43.05±19.53) μg/L,P＜0.05).No significant difference of the serum level of 25-(OH) D3 was found between patients refractory of GD and those with GD in remission((32.43±17.50) μg/L, (31.88±14.48) μg/L,P=0.866).However,compared with the normal control group,both diseased groups showed significantly decrease (P＜0.05).No correlation was found between serum 25-(OH) D3 and TRAb, FT3, Fr4 as well as TSH in GD group.No correlation was found between serum 25-(OH) D3 and TGAb, TPOAb (P＞ 0.05).Conclusion Serum vitamin D levels are decreased in patients with AITD, which has been speculated as a potential therapeutic method for AITD, though further investigations are needed to establish the precise role of 25-(OH) D3 in AITD.

The Correlation between Thyrotropin and Dyslipidemia in a Population-based Study

This study investigated the relationship between serum thyrotrophin levels and dyslipidemia in subclinical hypothyroid and euthyroid subjects. A total of 110 subjects with subclinical hypothyroidism and 1,240 euthyroid subjects enrolled in this study. Patients with subclinical hypothyroidism had significantly lower high density lipoprotein cholesterol (HDL-C) levels than those who were euthyroid. The lipid profiles were each categorized and mean thyrotrophin levels were higher in subjects in the dyslipidemia subclasses than subjects in the normal subclasses. Thyrotrophin was positively associated with serum triglyceride and negatively associated with serum HDL-C in women. Thyrotrophin was also positively associated with total cholesterol (TC) in the overweight population along with TC and LDL-C in overweight women. In the euthyroid population, thyrotrophin was positively associated with TC in the overweight population. In conclusion, serum thyrotrophin was correlated with dyslipidemia in subclinical hypothyroid and euthyroid subjects; the correlation was independent of insulin sensitivity.

Relationship betweenserum TSH and dyslipidemia / 中华内分泌代谢杂志

Objective To investigate the relationship between serum thyrotrophin(TSH)and dyslipidemia in subclinical hypothyroid and euthyroid subjects. Methods An epidemiological study on diabetes and thyroid diseases was performed in Dadong community, Shenyang city, in 2007. 110 subjects with subclinical hypothyroidism(SCH)and 1 240 euthyroid subjects were enrolled in the study. Neither history of thyroid diseases nor administration of thyroid-related and lipid-regulating medicines were reported in these subjects. The levels of serum thyroid hormones, lipids, fasting plasma glucose(FPG), and insulin were determined. Results (1)Patients with SCH had significantly lower HDL-C levels than those who were euthyroid.(2)According to the guideline of treatment of adult dyslipidemia in China, the lipid profiles were each categorized. Mean TSH levels were higher in subjects in the dyslipidemia subclass than subjects in the normal subclass. The differences were significant in high LDL-C subclass in overweight individuals. In euthyroid overweight women, mean TSH levels were significantly higher in high LDL-C subclass. In the euthyroid population, TSH was positively associated with total cholesterol in overweight population. The association was not modified by the homestasis model assessment for insulin resistance(HOMA-IR)values.(3)TSH was associated positively with serum triglycerides and negatively with serum HDL-C in women. TSH was positively associated with total cholesterol in overweight population and positively associated with total cholesterol and LDL-C in overweight women after adjustment for age, sex, and body mass index. Conclusion Raised serum TSH seems to be a risk factor of dyslipidemia in subclinical hypothyroid and euthyroid subjects, which is independent of insulin sensitivity.

Association of preoperative serum thyrotropin level with benign or malignant thyroid nodules / 中华内分泌代谢杂志

A total of 1 870 patients who had undergone thyroidectomy were investigated.The mean TSH level in patients with differentiated thyroid cancer (DTC) was significantly higher than that in patients with benign thyroid nodules[(1.95±1.69 vs 1.40±1.98)mIU/L,P＜0.01].DTC patients who had lymphatic metastasis or the diameter of tumor more than 10 mm had higher serum TSH level.Serum thyrotropin is an independent risk predictor for DTC.

The correlation of thyrotropin and the metabolic syndrome and its components / 中国实用内科杂志

Objective To explore the relationship between serum thyrotropin and the components of metabolic syndrome.Methods A total of 1534 adult inhabitants in Dadong district of Shenyang were asked to fulfill the questionnaires and have physical examination and oral glucose tolerance test(OGTT).The vein blood was drawn to measure thyrotropin(TSH),fasting plasma glucose(FPG),OGTT 2hPG,fasting insulin,triglyceride(TG) and high density lipoprotein cholesterol(HDL-C).Results Serum TSH in the MS group was higher than in the Non-MS group(2.54 vs 2.22 mU/L,P