Features And Significance Of Serum Apn Level In Type2Diabetic Coronary Heart Disease With Hypothyroidism

Objective: Diabetes and thyroid disease is two of the endocrine systemdisease, with two major disease incidence increased year by year, a largenumber of domestic and international research found diabetes in people withthe incidence of abnormal thyroid function was also increased, and withhypothyroid most. Adiponectin (APN) is a cellular factor, secreted by adiposecells,a large number of domestic and international documents reportedadiponectin levels in patients with type2diabetes is reduced, as type2diabetes coronary heart disease complications with the measurement of APNlevels are lower. Now, the pathogenesis of diabetes combined with thyroiddysfunction increase rate is still not clear, this research aims to study with type2diabetes when hypothyroidism plasma adiponectin variety characteristicsand the relationship between coronary heart disease, thus further reveals theconnection of hypothyroid with type2diabetes coronary heart disease.Methods: In this experiment，The subjects of groups1and2wereselected from January to February in2012. They came to our hospital physicalexamination of the age, sex matched subjects, The group1for the normalcontrol group (blood pressure, fasting blood glucose, postprandial2hoursblood glucose, lipids, electrocardiogram and thyroid function were normal,without a family history of diabetes), a total of30cases, of which male12,female18cases, aged between43-70. The group2for the simple type2diabetes mellitus group (formerly had been diagnosed or newly diagnosedtype2diabetic patients), a total of27patients, of which male14. female13cases, aged between40-66. Above volunteers are excluded by acute andchronic infection, malignant tumor, liver and kidney dysfunction and immunesystem disorders, but also denied having coronary heart disease,hypertension.etc. thyroid function test results were normal. The subjects of groups3and4were selected the Second AffiliatedHospital of Hebei Medical University in2010December to2012December inpatients with type2diabetes, type2diabetes mellitus candidates are in linewith the WHO (WHO)1999type2diabetes diagnosis standard. The group3for type2diabetes complicated with coronary heart disease group, a total of34patients,14were male,20female, age in the51-78years old, the normal ofthe thyroid; The group4for type2diabetes complicated with coronary heartdisease hypothyroidism group, a total of27patients,11were male,16female,age in the47-84years old, And thyroid test are in line with the subclinicalhypothyroidism or subclinical hypothyroidism diagnosis standard, above twocases exclude diabetic ketosis, acute and chronic infection, malignant tumor,liver and kidney dysfunction as well as the immune system disease, diabeticperipheral neuropathy, diabetic microangiopathy.etc.All subjects were collected from general information and tested relatedbiochemical indicators, but also the detection of plasma adiponectin levels,fasting blood glucose, fasting insulin, C reactive protein, a power levelindicator.All data using SPSS13.0statistical software. Test data choose test ofnormality, results in the normal data use the mean+SD, multiple comparisonbetween groups using analysis of variance, among group compared withS-N-K method; non normal data, results use median or the four percentileinterval, comparison group selection rank and inspection. Two indexcorrelation using Spearman correlation analysis, multiple regression analysisusing logistic regression analysis and multiple stepwise regression analysis.All the tests are bilateral, P <0.05was considered statistically significant.Results:1The age of group4was oldest among four groups,except group1and group2were compared no statistically significant (P>0.05), the rest comparisonbetween two groups are difference (P <0.05).Type2diabetes course: compared group2, group3and4are extended (P <0.001), between groups3and4was not statistically significant (P>0.05). Four groups of sex ratio, BMI comparison between were not statisticallysignificant (P>0.05).2Serum adiponectin (APN) level from group1to group4in turn reduce, fourgroups were compared between statistical significance (p <0.05), The group4was lowest. This difference in eliminating age after factors still exist.The groups2,3,4of CRP level were higher than group1(p <0.05); Group3was higher group2(p <0.05); the rest comparison between two groups are notdifference (P>0.05). Insulin resistance index:The group2was higher thanThe groups1,3,4(P <0.05), the rest comparison between two groups are notdifference (P>0.05)3Lipid spectrum: The groups2,3,4TG level was higher than group1(p <0.001); and The groups2,3,4HDL level was lower than group1(p <0.05);the rest comparison between two groups are not difference (P>0.05).Fourgroups of CHOL and LDL level comparison between were not statisticallysignificant (P>0.05).4he group4TSH level was higher than the groups1,3,4(P <0.001), the restcomparison between two groups are not difference (P>0.05).The FT3level ofthe groups1was higher than the groups2,3,4(P <0.05), and the FT3level ofthe groups2was higher than the groups3,4(P <0.01),except the group3and4comparison were no statistically significant (P>0.05), the rest comparisonbetween two groups are not difference (P>0.05). Four groups of FT4levelcomparison between were not statistically significant (P>0.05).5The relations between Plasma adiponectin (APN) level and hypertension,atherosclerosis:The group of atherosclerosis APN level was lowest than noatherosclerosis group (P<0.001).The APN level of hypertension group andBlood pressure normal group were compared no difference (p>0.05).6Plasma adiponectin, c-reactive protein level and general index, bloodbiochemical indexes and the results of the thyroid Spearman the correlationanalysis results:plasma adiponectin and age, blood pressure, FBG, TG, TSH,HbA1C, CRP, FINS, HOMA-IR a negative correlation;with HDL and FT3apositive correlation;And sex, CHOL, LDL, FT4, body mass index no significant correlation.CRP level and HDL plasma a negative correlation; Andblood pressure, TG, body mass index, FBG, HbA1C a positive correlation;withage, sex, CHOL, LDL, FT3, FT4,TSH, FINS, HOMA-IR no significantcorrelation.7Logistic regression analysis results: HbA1C, atherosclerosis, course, age aretype2diabetes complicated with coronary heart disease independent riskfactors; FT3for protective factor.8Multiple stepwise regression analysis results: FBG, TSH, HDL, HOMA-IR,arteriosclerosis and patients with type2diabetes plasma APN level have linearregression coefficients relations.Conclusion:1The study found that patients with type2diabetes serum APN level low thenormal control group, with the coronary heart disease was lower, especiallythe coronary heart disease with hypothyroidism was lowest.2Type2diabetes combined with atherosclerosis serum APN level wasreduced and the low level APN may be involved in the pathogenesis ofatherosclerosis.3Serum APN level and age, blood pressure, FBG, TG, TSH, HbA1C, CRP,FINS, HOMA-IR was negatively correlated; And HDL and FT3werepositively correlated.4The low level APN had close relationship with type2diabetes combinedwith cardiovascular disease happened and is independent risk factor.5Type2diabetes coronary heart disease patients when combined withhypothyroidism serum APN level was further lower, and the APN wasindependent risk factors for coronary heart disease, type2diabetes combinedwith hypothyroidism patients may through the APN mediated the occurrenceof coronary heart disease and progress.