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Objective:To explore the value of blood lipids, serum interleukin-6 (IL-6) and thyroid-stimulating hormone (TSH) detection in patients with differentiated thyroid cancer.Methods:From Mar. 2016 to Oct. 2021, 120 cases of DTC were admitted to the DTC group, 138 patients with benign thyroid nodules were included in the benign group, and 100 healthy people undergoing the physical examination in our hospital during the same period. were enrolled in the control group. Triglyceride (TG) , total cholesterol (TC) , high density liptein cholesterol (HDL-C) , low density lipoprotein (LDL-C) , IL-6, and TSH were compared between groups, and statistically significant indexes were included for multivariate analysis of the occurrence of DTC. The sensitivity, specificity and optimal cut-off value were analyzed, and their relationship with the clinicopathological characteristics of DTC patients was analyzed.Results:Serum TSH and IL-6 levels from high to low were malignant group, benign group and control group, and HDL-C levels from high to low were control group, benign group and malignant group ( P<0.05) . There was no significant difference in the levels of TC, TG or LDL-C ( P>0.05) . Multivariate Llogistics regression analysis indicated that TSH and IL-6 may be risk factors for the occurrence of differentiated thyroid cancer (all OR>1, P<0.05) . HDL-C may be a protective factor for the occurrence of differentiated thyroid cancer ( OR<1, P<0.05) . The ROC curve was drawn to determine the optimal cut-off value of TSH for the diagnosis of differentiated thyroid cancer, AUC: 0.985, sensitivity was 93.25%, specificity was 96.34%, 95% CI: 0.949-1.000 ( P<0.001) ; the best cut-off value of IL-6 for the diagnosis of differentiated thyroid cancer was 48.96 ng/L, AUC: 0.980, sensitivity was 96.98%, the specificity was 91.53%, 95%CI: 0.956-1.000 ( P<0.05) ; the best cut-off value of HDL-C for the diagnosis of differentiated thyroid cancer was 1.441 mmol/L, AUC: 0.0.691, the sensitivity was 85.10%, the specificity was 48.06%, 95%CI: 0.563-0.812 ( P<0.05) . The serum levels of TSH and IL-6 in patients with lymph node metastasis were significantly higher than those in patients without lymph node metastasis, and the level of HDL-C was significantly lower than those in patients without lymph node metastasis ( P<0.05) . TNM staging The serum levels of TSH and IL-6 in patients with stage III and IV were significantly higher than those in patients with stage I and II, and HDL-C was significantly lower than that in patients with stage I and II ( P<0.05) . Conclusions:Serum IL-6, TSH and HDL-C are closely related to the occurrence of differentiated thyroid cancer. The detection of serum IL-6, TSH and HDL-C is helpful for the differentiation of benign and malignant thyroid nodules. The presence or absence of lymph node metastasis in patients with differentiated thyroid cancer is related to TNM staging, and the detection value is high.
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Objective To observe the effect of insulin increasing-sensitivity agent- rosiglitazone on impaired glucose tolerance. Methods One hundred and forty cases of impaired glucose tolerence(IGT)were divided into two groups randomly. Eighty cases was intervented with physical activity, diet control and rosiglitazone in the treatment group ,60 cases were intervened with physical activity and diet control in the control group for 24 weeks. Clinical characteristics, including BMI, blood pressure, blood glucose, lipids profiles, insulin, C-peptide and urinary microalbumin excretion were compared between two groups. Results In the treatment group, fasting glucose and 2 h glucose significantly decreased from (5.7 ±0.9) mmol/L and (9. 6 ± 1.8) mmol/L at the baseline to (4.6 ±0.8)mmol/L and (7. 6 ± 1.2) mmol/L(P ＜0.01). In the treatment group,the urinary micro-albumin excretion,insulin resistance,triglyceride, fasting glucose and 2 h glucose were (246 ± 16)mg/24 h,2. 024 ± 0.427, (1.6 ± 0.8)mmol/L, (4. 6 ± 0.8) mmol/L and (7. 6 ± 1.2) mmol/L, which was significantly lower than those of (280 ± 12)mg/24 h ,3. 328 ± 0.462, (2. 5 ± 0.9) mmol/L, (5.5 ± 0.7) mmol/L and (8. 9 ± 1.3) mmol/L in the control group (P ＜0.01). The treatment significantly improved the insulin sensitivity from 80 ± 1 at the baseline to 198 ±8. In the treatment, the FINS and C-peptide were significantly decreased from (32 ± 9) mU/L and (3. 58 ± 1.60) g/L at the baseline to (21 ± 8) mU/L and (2. 52 ± 1.20) g/L(P ＜ 0.01). The blood pressure deceased significantly at the 24th week, and signfiantly different from those in the conrol group (P ＜ 0.05). After 48 weeks, 1 of the patients in the treatment group developed into type 2 diabetes mellitus,whereas 8 patients developed into type 2 diabetes mellitus in the control group,which was significantly higher than that in the treatment group (P ＜0.05). The rate of side effects in the treatment group was similar with that in the control group, no liver function impair etc has been observed. Conclusions Rosiglitazone has significant effect on decreasing the blood sugar and decreasing the fasting insulin and C-peptide in patients with impaired glucose tolerancem improving the insuhn sensitivity of the circumference tissue, and can prevent or postpone the progression of IGT to type 2 diabetes mellitus in patients at risk of developing the disease.