Application Of Different Assessment Methods And Thyroid Function In 10-Year Cardiovascular Disease Risk Assessment Of T2DM

Objective:Use the Framinghan rating scale and the "Cardiovascular risk assessment for diabetes mellitus,,model to assess the occurrence risk of cardiovascular disease in patients with T2DM over the next 10 years,analyze the consistency of two assessment methods.Use the ADVANCE-Risk scale and the "CV Risk assessment" model to assess the mortality risk of cardiovascular disease in T2DM patients over the next 10 years.Analyze the consistency of two assessment methods.To detect the thyroid function of SCH and analyze the relationship between TSH and the related indicators of cardiovascular disease,and to explore whether SCH should be considered as a risk factor in the assessment of occurrence and mortality risk of cardiovascular disease in patients with T2DM in the next 10 years.Methods:Collect a total of 527 inpatients who met the diagnostic criteria for T2DM in the enendocrinology department of the second affiliated hospital of kunming medical university from January 2018 to December 2020:1.Use the Framinghan rating scale and the "Cardiovascular risk assessment for diabetes mellitus" model to assess the occurrence risk of cardiovascular disease over the next 10 years.2.2.Bring a total of 148 patients with increased duration of diabetes,albumin/creatinine ratio and other indicators into study,use the ADVANCE-Risk scale and the "CV Risk assessment" model to assess the mortality risk of cardiovascular disease over the next 10 years.Use Kappa values to evaluate the consistency of two methods respectively.3,There were 100 patients in T2DM combined with SCH in this study,without the history of valvular heart disease or cardiomyopathy,as the case group(group DM+SCH),a total of 100 patients with normal thyroid function without history of valvular heart disease or cardiomyopathy were stratified and randomly selected as the control group(group DM),to collect the basic、biochemical and image data of all patients,using the t-test of two independent samples for inter-group comparison,and the Pearson to analyze the correlation between TSH and blood lipids such as Total Cholesterol(TC),triglyceride(TG)and cardiac function indexes such as Left ventricular ejection fraction(LVEF)and cardiac output(CO),cardiac index(CI)and ratio of early and late mitral orifice diastolic filling speed(peak E/A).Results:1.The result of "Cardiovascular risk assessment for diabetes mellitus"model:431 patients(81.78%)in the medium-risk group,and 250 patients(47.44%)in the high-risk group using Framinghan rating scale.SPSS analysis obtained Kappa value,K=0.051,P=0.001,indicating that the consistency between "Cardiovascular risk assessment for diabetes mellitus" model and Framinghan rating scale was very poor.2.The result of "CV Risk assessment":98 patients(66.22%)in the very high Risk group,and 76 patients(50%)in the ADVANCE Risk model.SPSS analysis obtained Kappa value,K=0.492,p=0.000,indicating that the consistency between"CV Risk assessment" model and the Advance Risk model is moderate.3.There were 100 patients with SCH among all the patients in this study,the prevalence rate is 18.98%.The female cases in DM+SCH group were significantly higher than DM group,the difference was statistically significant(P<0.05).Compared with DM group,the concentration of TSH in DM+SCH group was significantly increased,TT3,FT3,TT4,FT4 and RT3 were all decreased,and TG-Ab was significantly increased,with statistically significant difference(P<0.05,P<0.01).The concentration of TC,LDL-C and LDL-C/HDL-C in DM+SCH group were higher than those in DM group,and the differences were statistically significant(P<0.01).In DM+SCH group,CO,LVEF,E peak,E/A ratio decreased,and vascular resistance increased,with statistically significant difference(P<0.05,P<0.01).4.In this study,Pearson analyze showed that TC and LDL-C was positively correlated with TSH(P<0.05,P<0.01),and CO,LVEF,E peak,E/A ratio was negatively correlated with TSH(P<0.05,P<0.01),and vascular resistance was positively correlated with TSH(P<0.05).Conclusions:1.In this study,the "Cardiovascular risk assessment for diabetes mellitus" model and Framinghan rating scale in assessing the occurrence risk of cardiovascular disease in patients with T2DM in the next 10 years were very inconsistent.The "CV Risk assessment" and ADVANCE Risk model had moderate consistency in assessing the mortality risk of cardiovascular in patients with T2DM over the next 10 years.2.Blood lipid and partial heart function is related to TSH level in patients of T2DM with SCH.3.SCH should be regarded as a risk factor in the assessment of the occurrence and mortality risk of cardiovascular disease in patients with T2DM over the next 10 years.