Impact of subclinical hypothyroidism on metabolic risk factors of type 2 diabetes mellitus / 中国医师进修杂志

ABSTRACT

Objective To compare and explore impact of subclinical hypothyroidism on metabolic risk factors of type 2 diabetes mellitus.Methods A total of 204 inpatients with type 2 diabetes mellitus.The patients were divide into two groups according to whether complicated with subclinical hypothyroidismcombination of simple type 2 diabetes mellitus (150 cases) and type 2 diabetes mellitus with SCH group(54 cases),two groups of age,gender,duration were no statistical difference.and collecting the clinical data of two groups of patients by Professional people,detection of blood lipids,glycated hemoglobin (HbA1c),uric acid (UA),Oral glucose tolerance test (OGTT),insulin and C peptide releasing test were taken in all groups.The improvement of insulin,C peptide index [HOMR-islet(CP)] and whole body insulin sensitivity index (ISIcomp) were used to estimate insuhn sensitivity,and improvement of insulin,C peptide secretion index [HOMR-isle (CP)] was used to evaluate the function of pancreatic islet β cell.T test was used for statistic alanalysis.Risk factors of type 2 diabetes mellitus with microvascular Complication by using Logistic regression analysis.Results (1) Compared with type 2 diabetes mellitus group,blood pressure,body mass index (BMI),triglycerides(TC),Low density lipoprotein cholesterol (LDL-C),UA,fasting C peptide(C-P0),postprandial 120 min C peptide(C-Pm),HOMA-IR(CP) were increased (P ＜ 0.05),while fasting blood glucose(FPG),bloods glucose in postprandial 120 min (G120),HbA1c,ISI-comp were decreased (P ＜ 0.05).(2) The incidence of diabetic nephropathy was higher in diabetic patents with subclinical hypothyroidism than those without subchnical hypothyroidism,the difference was statistically significant (P ＜ 0.05).(3) Logistic analysis showed that duration,SBP,TSH were the major risk factors of type 2 diabetes mellitus with nephropathy (P ＜ 0.05).Conclusions Type 2 diabetes mellitus patients with subclinical hypothyroidism compared to pure insulin resistance is more obvious,the degree of lipid metabolism disorders more severe.Elevated TSH can predict the occurrence of diabetic nephropathy in type 2 diabetes mellitus.