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Objective:To investigate the relationship between serum thyroid hormone levels in the normal range and body weight, blood glucose, blood lipids, and other obesity-related indexes in patients with type 2 diabetes mellitus.Methods:Seventy obese patients with type 2 diabetes mellitus and ninety-two patients with type 2 diabetes mellitus with normal weight who were treated in the Nangang Branch of Heilongjiang Provincial Hospital from May 2020 to May 2021 were included in this study. Thyroid-stimulating hormone level was in the normal range (0.35-4.94 mU/L) in all participants. Serum levels of free triiodothyronine, free thyroxine, thyroid-stimulating hormone, thyroid peroxidase antibody, thyroglobulin antibody, triglyceride, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, fasting blood glucose, glycosylated hemoglobin, fasting C peptide, fasting insulin, systolic blood pressure, diastolic blood pressure, and serum uric acid were measured in all participants.Results:Free triiodothyronine level was positively correlated with fasting blood glucose and glycosylated hemoglobin levels ( r = 0.19, P = 0.021; r = 0.21, P = 0.017). Free thyroxine level was positively correlated with serum glycosylated hemoglobin level ( r = 0.25, P = 0.009) and negatively correlated with total cholesterol ( r = -0.17, P = 0.029). Thyroid-stimulating hormone level was positively correlated with body mass index as well as total cholesterol and low-density lipoprotein cholesterol levels ( r = 0.33, P < 0.001; r = 0.33, P < 0.001; r = 0.32, P < 0.001). Conclusion:Thyroid hormones in the normal range play an important role in the regulation of body weight, blood glucose, and blood lipids in patients with type 2 diabetes mellitus. Blood glucose level increases markedly in patients with relatively high free triiodothyronine and free thyroxine levels. The risks of obesity and dyslipidemia increase in patients with relatively high serum thyroid-stimulating hormone levels
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Objective To investigate the prevalence and risk predictors of depressive tendency in type 2 diabetic patients with peripheral neuropathy.Methods From May 2017 to December 2017,150 diabetic patients with peripheral neuropathy and 150 diabetic patients without peripheral neuropathy in the First Affiliated Hospital of Harbin Medical University were collected.The general clinical data,including age,sex,diabetic duration,height,weight,body mass index (BMI),fasting blood glucose (FBG),fasting insulin (FINS),homeostasis modal assessment-insulin resistance index(HOMA-IR),glycated hemoglobin(HbA1c),blood lipid and blood pressure were collected.The motor nerve and sensory nerve conduction velocity of lower limbs were measured by electromyograph.Zung depression self-rating scale(SDS) was used for self-rating of depression syndrome.Results There were 46 cases(30.67％) suffered from depression(SDS ＞50) in the neuropathic group,and 25 cases(16.67％) suffered from depression in the non-neuropathic group.The incidence rate of depression in the neuropathic group was significantly higher than that in the non-neuropathic group and tended to be severe (x2 =12.732,P =0.005).Non-conditional Logistic multivariate stepwise regression analysis showed that sex,the course of diabetes and low density lipoprotein (LDL) were associated with depressive tendency (x2 =3.994,P =0.049;x2 =5.334,P =0.032;x2 =6.172,P =0.020).Conclusion The prevalence of depression in diabetic patients with peripheral neuropathy is higher and tends to be severe.Sex,the course of diabetes and LDL are risk factors of depressive tendency.
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Objective To observe the morbidity and clinical characteristics of primary aldosteronism (PA) in newly diagnosed patients with hypertension.Methods 255 patients with newly diagnosed high blood pressure were determined plasma renin activity (PRA),angiotensinⅡ(ATⅡ),aldosterone (PAC),cortisol (COR),adrenocortico-tropic hormone (ACTH)and 24h urinary vanilmandelic acid (VMA).They were examined renal artery color doppler and adrenal 64 row CT scan +enhancement scanning.Results 179 patients (70.20%)were diagnosed essential hypertension (EH).In EH patients,24 cases (13.41%)with hypokalemia.42 patients (16.47%)were diagnosed PA.In PA patients,18 cases (42 .86 %)with hypokalemia,25 cases(5 9 .5 2 % )with unilateral adrenal adenoma. Compared with EH patients,there were higher level of high density lipoprotein (HDL -C)(Z =-2.068,P =0.036),lower level of total cholesterol (TC),low density lipoprotein (LDL -C),fasting plasma glucose (FPG), serum kalium (Z =3.594,P =0.000;Z =2.807,P =0.005;Z =3.499,P =0.000;Z =8.435,P =0.000)in PA patients.The levels of plasma PRA and ATⅡin PA patients were lower than in EH patients(Z =3.673,P =0.000;Z =2.215,P =0.026).The levels of plasma PAC and ARR were higher than in EH patients (Z =8.562,P =0.000;Z =19.871,P =0.000).The minimum value of plasma PAC was 292.1pg/L,the ARR was 376.7 in 42 PA patients. The maximum value of plasma PAC was 311.3pg/L,and the ARR was 291.2.Conclusion There is high detection rate of PA in newly diagnosed hypertension.The unilateral adrenal adenoma is a main cause of PA.Hypokalemia is not common in PA patients.PA has little influence on glucolipid metabolism.ARR has high differential diagnosis accuracy for PA and EH.
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Objective To investigate the relationship between the polymorphisms of angiotensin Ⅱ receptor gene and the risk of primary aldosteronism (PA).Methods Polymerase chain reaction -restriction fragment length polymorphism (PCR -RFLP)was used to examine the 1 1 66A /C polymorphism of AT1 R gene and 1 675A /G poly-morphism of AT2R gene in 85 patients with PA and 1 00 healthy controls.Results There was no significant difference of AT1 R 1 1 66A /C genotypes (AA,AC,CC)and allele (A and C)frequency among patients and controls (χ2 =0.430,P =0.806).There was obvious difference of AT2R 1 675A /G genotypes (AA,AG,GG)and allele (A and G) frequency among two groups (χ2 =6.1 21 ,P =0.01 3).The G allele was higher than A allele in PA group (χ2 =6.767,P =0.009).Conclusion Homogenic mutation of 1 675A /G site in AT2R gene may be one of risk factors of PA.