The Positive Association between Subclinical Hypothyroidism and Newly-Diagnosed Hypertension Is More Explicit in Female Individuals Younger than 65

Background@#Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. @*Methods@#Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. @*Results@#The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. @*Conclusion@#The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

The Positive Association between Subclinical Hypothyroidism and Newly-Diagnosed Hypertension Is More Explicit in Female Individuals Younger than 65

Background@#Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. @*Methods@#Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. @*Results@#The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. @*Conclusion@#The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Controlled clinical trial with the combination therapy with metformin, thiazolidinediones, glucagon-like peptide 1 analog in patients with type 2 diabetes and metabolic syndrome / 中华内分泌代谢杂志

Objective@#The aim of this study was to compare the efficacy and safety of metformin/thiazolidinediones (TZDs) / glucagon-like peptide 1 (GLP-1) analogs (triple therapy) with conventional glucose-lowering therapy(conventional therapy) for patients with type 2 diabetes and metabolic syndrome.@*Methods@#A prospective randomized-controlled 26-week study was carried out. A total of 82 patients with type 2 diabetes and metabolic syndrome were randomized to receive either triple therapy protocal or just conventional therapy, altogether with 41 cases in each group.@*Results@#HbA1C value was significantly reduced in triple therapy group versus the conventional therapy group [(2.23±1.75)% vs (1.48±1.59)%, P<0.05]. Values of body mass index, waist circumference, and visceral fat area were significantly reduced in triple therapy group as compared to those of conventional therapy group [(2.50±1.81 vs 0.92±1.82)kg/m2, (6.75±4.92 vs 1.66±3.25)cm, (24.10±19.10 vs 10.02±20.10)cm2, all P<0.01, respectively]. Control rates of HbA1C and fasting plasma glucose for triple therapy were higher than those for conventional therapy (both P<0.05). No hypoglycemia occurred in triple therapy group. Subjects receiving triple therapy experienced more frequent gastrointestinal side effects than those in conventional therapy group (18.87% vs 3.92%, P<0.05). The most common side event was mild nausea (90%).@*Conclusion@#Combination therapy with metformin/TZDs/GLP-1 analogs had statistically significant advantages in the control of body weight, waist circumference, and visceral fat area in addition to the control of blood glucose over conventional glucose-lowering therapy in our patient cohort, it seems to be an optimized therapeutic regimen for patients with type 2 diabete and metabolic syndrome.

Controlled clinical trial with the combination therapy with metformin, thiazolidinediones, glucagon-like peptide 1 analog in patients with type 2 diabetes and metabolic syndrome / 中华内分泌代谢杂志

Objective The aim of this study was to compare the efficacy and safety of metformin/thiazolidinediones (TZDs) / glucagon-like peptide 1 (GLP-1) analogs (triple therapy) with conventional glucose-lowering therapy ( conventional therapy ) for patients with type 2 diabetes and metabolic syndrome. Methods A prospective randomized-controlled 26-week study was carried out. A total of 82 patients with type 2 diabetes and metabolic syndrome were randomized to receive either triple therapy protocal or just conventional therapy, altogether with 41 cases in each group. Results HbA1C value was significantly reduced in triple therapy group versus the conventional therapy group [(2.23 ± 1.75)％ vs (1.48 ± 1.59)％, P<0.05]. Values of body mass index, waist circumference, and visceral fat area were significantly reduced in triple therapy group as compared to those of conventionaltherapygroup[(2.50±1.81vs0.92±1.82)kg/m2,(6.75±4.92vs1.66±3.25)cm,(24.10±19.10vs 10.02±20.10)cm2, all P<0.01, respectively]. Control rates of HbA1C and fasting plasma glucose for triple therapy were higher than those for conventional therapy ( both P<0. 05 ) . No hypoglycemia occurred in triple therapy group. Subjects receiving triple therapy experienced more frequent gastrointestinal side effects than those in conventional therapy group ( 18. 87％ vs 3. 92％, P<0. 05 ) . The most common side event was mild nausea ( 90％) . Conclusion Combination therapy with metformin/TZDs/GLP-1 analogs had statistically significant advantages in the control of body weight, waist circumference, and visceral fat area in addition to the control of blood glucose over conventional glucose-lowering therapy in our patient cohort, it seems to be an optimized therapeutic regimen for patients with type 2 diabete and metabolic syndrome.

The Relationship between Thyroid Hormone and Purine Metabolism and Body Weight in Patients with Type Ⅱ Diabetes and Normal Thyroid Function / 昆明医科大学学报

Objective To investigate the relationship between thyroid hormone and uric acid (UA) and body mass index (BMI) in patients with type Ⅱ diabetes and normal thyroid function.Methods Total of 313 patients with type Ⅱ diabetes and normal thyroid function were selected.BMI,fasting blood glucose (FBG),the metabolism of blood lipid,thyroid hormones and UA indicators were examined and the correlations of thyroid hormone,BMI and UA were analyzed.Results (1) The patients were divided into two groups according to gender,and FT3,FT4,and UA of male were found to be significantly higher than those in female (P＜0.01).TSH,SBP,HDL-C in female were significantly higher than those in male (P＜0.01);(2) The patients were divided into three groups according to BMI Level.Thyroid-stimulating hormone (TSH),three iodine armour gland original glycine (TT3),free three iodine thyroid glycine (FT3),UA,and FBG in overweight and obesity groups were found to be higher than those in normal weight group (P ＜ 0.05);(3) The patients were divided into two groups according to the TSH level.Serum uric acid,TT3,FT3,fasting insulin in the group with TSH above 2.5 uIU/L were found to be higher than those in the group with TSH under 2.5 uIU/L (P ＜ 0.05);(4) Patients were divided into two groups according to the UA level.TSH,FT3 in male with high uric acid were found to be higher than those in male with normal uric acid (P ＜ 0.05);TSH was in female with high uric acid was found to be higher than that in female with normal uric acid (P ＜ 0.05).Conclusion Thyroid hormone in patients with type Ⅱ diabetes can be used to assess the body weight and uric acid,which is of great clinical importance.

The Clinical and Biochemical Features of Patients with Type 2 Diabetes Complicated by Subclinical Hypothyroidism / 昆明医科大学学报

Objective To investigate the effects of subclinical hypothyroidism (SCH) on blood glucose and metabolic parameters in type 2 diabetes (T2DM) . Methods A total of 973 T2DM patients were recruited, and the clinical data, biochemical and thyroid function parameters were measured. One hundred and forty eight T2DM patients were diagnosed as SCH (SCH group) and 152 euthyroid patients were selected as control group (NSCH group) . Results (1) The prevalence of SCH in type 2 diabetes was 15.3% (148/973) . (2) Compared with the NSCH group, the prevalence of overweight/obesity was significantly higher in SCH group (54.1%vs 35.5%,<0.01) as well as hypertension (64.9%vs 52%, <0.05) . There was no significant difference in HbA1c control and prevalence of dyslipidemia and hyperuricemia between two groups. Conclusion SCH may have some adverse effects on blood pressure and BMI in T2DM.

Early warning and intervention of nocturnal hypoglycemia in patients with type 2 diabetes mellitus / 中华内分泌代谢杂志

Objective To investigate risk factors of nocturnal hypoglycemia in patients with type 2 diabetes mellitus,to seek quantitative indicators for early warning,and to evaluate the effects of intervention.Methods 24-h blood glucose of 1147 patients with type 2 diabetes mellitus with well-controlled hyperglycemia were determined by continuous glucose monitoring system (CGMS).Incidences of hypoglycemia were compared between groups with different 3 h postprandial blood glucose levels after supper.Results The rates of hypoglycemia,asymptomatic hypoglycemia,and nocturnal hypoglycemia were respectively 37.23％,22.75％,and 18.31％.Nocturnal hypoglycemia set in most frequently by 22:00-2:00 (RR =1.72,x2 =31.667,P＜0.01).The hypoglycemia incidence was reduced in intervention group than that in control group (9.67％ vs 16.76％,x2 =8.79,P ＜0.01).Conclusions Nocturnal hypoglycemia happens commonly in patients with type 2 diabetes.It usually sets in by 22:00-2:00.Appropriate intervention may prevent the hypoglycemic events.

Levothyroxine dosage and related factors in the treatment of pregnant women with subclinical hypothyroidism / 中华内分泌代谢杂志

Objective To study the levothyroxine doses and related factors in the treatment of pregnant women with subclinical hypothyroidism (SCH).Methods Fifty-six pregnant women with SCH (diagnosed before 12 weeks of gestation) were recruited and divided into 2 groups according to the baseline TSH levels,SCH group 1 (2.5 mIU/L ≤ TSH ≤ 5.0 mIU/L,n =24) and SCH group 2 (TSH＞5.0 mIU/L,n =32).Thyroid autoantibodies [thyroid peroxidase antibody(TPOAb) and thyroglobulin antibody(TGAb)] were detected.All the subjects were treated with levothyroxine and the doses were adjusted according to the TSH level.The therapeutic target was to keep the TSH levels under control,0.3 to 2.5 mIU/L for the first trimester and 0.3 to 3.0 mIU/L for the second and third trimesters.Results There was a positive correlation between the levothyroxine doses and baseline TSH levels (r =0.533,P＜0.01) in pregnant women with SCH.A significant difference in the levothyroxine doses between SCH group 1 and SCH group 2 was found [(0.583 ± 0.341) vs (0.961 ± 0.405) μg/kg,t =-3.695,P＜ 0.01].The levothyroxine doses in SCH group 2 were 64.84％ higher than those in group 1.There was a significant difference in the levothyroxine doses between thyroid autoantibody negative and positive subjects [(0.680 ± 0.370) vs (0.918 ±0.440) μg/kg,t =-2.197,P =0.032].The levothyroxine doses in thyroid autoantibody positive subjects were 35 ％ higher than those in the negative subjects.In addition,there was a significant difference in the levothyroxine doses between subjects with negative and positive thyroid autoantibody [(0.421 ± 0.192) vs (0.720 ± 0.385)μg/kg,t =-2.331,P =0.029] in SCH group 1.While in SCH group 2,the difference did not reach statistical significance.Conclusion The baseline TSH levels and status of thyroid autoantibodies may affect the levothyroxine dosage in pregnant women with SCH.

Investigation of thyroid function parameters in subclinical hypothyroid women treated with levothyroxine during pregnancy / 中华内分泌代谢杂志

Subclinical hypothyroidism during pregnancy is associated with some adverse outcomes during maternal pregnancy.The present study investigated thyroid function parameters measured by electroehemiluminescence (ECL) immunoassays in subclinical hypothyroid women treated with levothyroxine (L-T4) during pregnancy.The results showed that in evaluating thyroid function with ECL immunoassays during replacement with L-T4,determination of serum TT4 appears to have a closer correlation with TSH and may better reflect the effìcacy of treatment.

Evaluation of nocturnal hypoglycemia in patients with type 2 diabetes via continuous glucose monitoring system / 中华内分泌代谢杂志

The variation of blood glucose in 1 147 patients with type 2 diabetes mellitus was monitored by continuous glucose monitoring system(CGMS). The results showed that the peak hours of nocturnal hypoglycemia occurred during 22 : 00-2 : 00. The incidence of nocturnal hypoglycemia was negatively correlated with mean blood glucose and blood glucose at three hours after supper. The probability of hypoglycemia was up to 50% when blood glucose level had been as low as 4. 7 mmol/L at 3 h after supper.

Study on the association between the different levels of C-peptide of type 2 diabetes and colorectal cancer risk / 中国糖尿病杂志

To study on the association between the different levels of C-peptide of type 2 diabetes and colorectal adenoma and cancer risk.We detected the concentration of serum C-peptide in 45 type 2 diabetes who were diagnosed as colorectal adenoma and cancer.It showed that serum C-peptide level was higher in type 2 diabetes with colorectal adenomas and cancer than without colorectal adenomas and cancer.The serum C-peptide level may have relationship with colorectal adenomas and cancer.

Effects of Metformin on the Polycystic Ovary Syndrome With Pseudoacanthosis Nigricans and Insulin Resistance / 中国医师杂志

Objective To understand how resistance and whether its compensatory hyperinsulinemia will influence the ovulatory function and sex hormone level,especially in the testosterone level and blood lipid level and to observe the effects of metformin on the polycystic ovary syndrome with pseudoacanthosis nigricans and the insulin resistance.Methods The method of the research is to carry out a three-month tretment for 30 patients who were suffering from the polycystic ovary syndrome with the pseudoacanthosis nigricans and the insulin resistance.During the treatment much attention was drawn to the following aspects of the patients.Such as the body mass index,the waist hip ratio,the fasting blood glucose,the fasting insulin,two hours after postcibal blood glucose and postcibal insulin,the insulin sensitive index,the change of blood lipid and sex hormone level,and the skin lesion change.Results After the treatment,all the indexes fell except that the insulin sensitive index rose.There was significancely difference(P

Effect of acarbose on the aortic collagen nonenzymatic glycosylation in diabetic rats / 中国病理生理杂志

AIM: To observe the effect of ?-glucosindase inhibitor, acarbose on the aortic collagen nonenzymatic glycosylation in streptozotocin-induced diabetic rats . METHODS: The treated group (DM+A) was given acarbose (1 mg?kg -1 ). The aortic collagen and its AGEs concentration were measured at the scheduled periods (1, 3 and 6 months ). RESULTS: During the observed period , the aortic collagen and its AGEs concentration were higher than that of control group in a time-dependent manner (P