| Objective:To study the correlation between the level of serum FT3 and the prevalence of retinopathy in type 2 diabetes with normal thyroid function.Method:Clinical data was from 463 patients with type 2 diabetes who were admitted in endocrinology department of the First Affiliated Hospital of Nanchang University from August in 2018 to July in 2019,all of the patients’ information and medical examination were completed within 48 hours,including patients’ basic information,treatment status,past history,laboratory test indicators,fundus photography and other data.A total of 414 patients aged ≥18 years and excluding thyroid dysfunction and incomplete clinical data were included in this study.Patients with type 2 diabetes with normal thyroid function were divided into non-diabetic retinopathy(NDR)group,background DR(BDR)group and proliferative DR(PDR)group according to the results of fundus examination,fundus photography and fluorescein fundus angiography.According to the quartile level of FT3,FT4 and TSH,it was divided into four groups.To compare the differences in the present incidence of FT3,FT4 and TSH,and the correlations between different TSH,FT3,FT4,HbA1 c and tpo-ab groups and DR.To analyze the correlation between FT3 and other clinical characteristics and the risk factors for retinopathy in type 2 diabetic patients with normal thyroid function.Datas were analyzed using SPSS version 22.0.And P<0.05 was considered statistically significant.Result:(1)A total of 463 patients were collected,and those with incomplete data and abnormal thyroid function were excluded.A total of 414 patients were included in this study,273 males and 141 females,with the mean age of 57.67±10.90 years and an average course of disease of 9.39±6.43 years.HbA1 c ranged from 4.4 to 16.9%.There were 142 cases in the NDR group and 272 cases in the DR group,among which 215 cases in the BDR group and 57 cases in the PDR group.(2)Compared the clinical data and biochemical indicators of DR and NDR patients : There were no statistically significant differences between sex,age,body weight,systolic blood pressure,diastolic blood pressure,HbA1 c,2hPBG,FBG,TG,TC,LDL-C,HDL-C,TPO-Ab,TG-Ab,TSH and FT4 course between two groups(P all>0.05).FT3 in the DR group was lower than that in the NDR group,with a statistically significant difference(P<0.05).Compared with NDR group,the DR group has significantly longer duration of diabetes,and the differences was statistically significant(P<0.01).(3)The relationship between serum FT3 level and DR: In patients with T2 DM risk of diabetic retinopathy,there were statistically significant differences between increasing quartiles of FT3(P<0.01).The prevalence of diabetic retinopathy decreased with the increase of FT3.(Ptrend = 0.018)(4)The risk of DR in patients with the lowest serum FT3 score was 2.231 times higher than that of patients with the highest serum FT3 score.By gender analysis,when FT3<2.52pg/ml,there was a high DR risk in men(OR=3.088,P<0.05),and no high DR risk in women(P>0.05).This result was still supported after adjusting for diabetes course,systolic blood pressure,diastolic blood pressure,age,HbA1 c,TG,TC,LDL-C,HDL-C and other factors.Therefore,the closer the serum FT3 level was to the lower limit of the normal value,the higher the risk of developing DR in the male patients with type 2 diabetes.(5)There was no significance in the prevalence of DR between FT4,TSH groups.(6)FT3 had a positive correlation with FT4、diastolic blood pressure、 body weight and Smoking history;and a negative correlation with DR,gender,HDL-C,TPO-Ab.FT4 had a positive correlation with diastolic blood pressure、body weight,HbA1 c,FPG and the usage of metformin;as well as a negative correlation with gender,While TSH had a positive correlation with gender,a negative correlation with smoking history.Spearman correlation analysis showed that there was a positive correlation between DR and the course of diabetes;and a negative correlation between DR and FT3.(7)DR as the dependent variable,FT3 as the independent variable,binary Logistic regression analysis showed that FT3 was the independent negative factor that affected DR.When adjusted for HbA1 c,gender,age,weight,there were no statistically significant differences between FT3 and DR(P>0.05).Conclusion:1.There were no statistically significant differences between serum FT3 levels and DR in euthyroid patients with type 2 diabetes.2.The longer the course of the disease and the lower the body weight,the higher the risk of diabetic retinopathy.Duration of disease and weight were independent risk factors for DR.3.The serum thyroid hormone level in type 2 diabetes patients is closely related to the patient’s gender,blood sugar,blood lipid,blood pressure,weight and other factors.Changes in diabetes condition can affect the thyroid hormone level,so regular screening of thyroid function is particularly important. |
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