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

ABSTRACT

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.