Serum Osteocalcin In Patients With Hashimoto’s Disease Complicated With Subclinical Hypothyroidism Study On Glucose And Lipid Metabolism

Objective（s）:（1）To determine the characteristics of osteocalcin（OC）,glucose and lipid metabolism in patients with Hashimoto Thyroiditis（HT）combined with subclinical hypothyroidism（SCH）.（2）To determine the correlation between OC and glucose and lipid metabolism,thyroid function and the risk factors for theoccurrence of SCH and OC reduction in patients with HT SCH group.Methods:A case-control study was used to select≥18 years of age,men aged<50 years,women who were not menopausal,with first-onset,untreated HT as the HT group（n=121,age 23-53 years）,23 men（26-49 years）and 98 women（23-53 years）,HT was divided into normal thyroid function HT₀group（n=63）,SCH HT₁group（n=58）,divided into OC normal HT₂group（n=85）and OC reduction HT₃group（n=36）according to whether OC was reduced,and gender-matched health examiners were the control group（NT）（n=58,age 22-49 years）,10 cases（24-45 years）in men and 48cases（22-49 years）in women;all subjects’sex,age,Body Mass Index（BMI）,thyroid function indicators[Free Triiodothyronine（FT₃）,Free Thyroxine（FT₄）,Thyroid stimulating Hormone（TSH）,Thyroid Peroxidase Antibody（TPOAb）,Thyroglobulin Antibody（Tg Ab）],Fasting Plasma Glucose（FPG）,Triglyceride（TG）,Total Cholesterol（TC）,Low-density Lipoprotein（LDL-C）,High-density Lipoprotein（HDL-C）,Serum Uric Acid（SUA）,Serum Creatinine（Scr）,Estimated Glomerular Filtration Rate（e GFR）,Triglyceride And Glucose Index（Ty G Index）,and Calibration Atherogenic Index Of Plasma（c AIP）,and compare the group differences among the above indexes and analyze the correlation between the above indexes.The risk factors of HT,SCH,OC reduction,dyslipidemia,Hyperuricemia（HUA）,Ty G Index increment and c AIP increment were analyzed by binary logistic regression.Results:（1）The age,BMI,TG,TC,LDL-C,and the percentage of e GFR reduction,Ty G index,and the percentage of Ty G index increment,c AIP,and the percentage of c AIP increment were higher in the HT group than in the NT group,and e GFR was lower than in the NT group（P<0.05）.Age,TG level and the percentage of TG increment,the percentage of TC increment,dyslipidemia,combined HUA,e GFR reduction,Ty G index and the percentage of Ty G index increment,c AIP and the percentage of c AIP increment were all higher in the HT₁group than in the HT₀group（P<0.05）.Age and TPOAb were higher in the HT₃group than in the HT₂group,and FT₃was lower than in the HT₂group（P<0.05）.（2）The mean OC values were lower in the NT group≥30 years（n=36）compared with 18-29 years（n=22）（P<0.05）,in the HT group≥30 years（n=103）compared with 18-29 years（n=18）（P<0.05）,and in the HT₀group≥30 years（n=53）compared with 18-29 years（n=10）（P<0.05）.（3）Mean OC values were lower in HT women（n=98）compared to men（n=23）（p<0.05）.（4）OC was negatively correlated with female（r=-0.231,P<0.05,r=-0.283,P<0.05,r=-0.336,P<0.05）and positively correlated with FT₃（r=0.197,P<0.05,r=0.271,P<0.05,r=0.273,P<0.05）in the total groups,HT group,and SCH group.OC was negatively correlated with age（r=-0.388,P<0.05,r=-0.295,P<0.05）in the total groups and the HT group.OC was negatively correlated with BMI in the total groups（r=-0.162,P<0.05）,and OC was positively correlated with SUA（r=0.176,P<0.05,r=0.267,P<0.05）in the total groups and SCH group.（5）In the total groups（1）every 10 years of age increment（OR=1.524,P<0.05）and dyslipidemia（OR=36.523,P<0.05）were risk factors for the occurrence of HT.（2）every 10 years of age increment was a risk factor for the OC reduction（OR=1.696,P<0.05）.（3）every 10 years of age increment（OR=1.675,P<0.05）,BMI≥24Kg/m²（OR=2.584,P<0.05）,Tg Ab positive（OR=3.977,P<0.05）,TSH>4.74m IU/l（OR=2.392 P<0.05）were risk factors for the occurrence of dyslipidemia,but in women were protective factors for the occurrence of dyslipidemia（OR=0.360,P<0.05）.（4）BMI≥24Kg/m²（OR=3.165,P<0.05）and TSH>4.74m IU/l（OR=1.936,P<0.05）were risk factors for the development of HUA.（5）Every 10 years of age increment（OR=1.732,P<0.05）,BMI≥24Kg/m²（OR=2.144,P<0.05）,and dyslipidemia（OR=9.781,P<0.05）were risk factors for Ty G index increment.（6）BMI≥24Kg/m²（OR=2.776,P<0.05）and dyslipidemia（OR=8.055,P<0.05）were risk factors for c AIP increment,and women were protective factors（OR=0.346,P<0.05）.（6）In HT group（1）Dyslipidemia was a risk factor for the development of SCH（OR=2.646,P<0.05）.（2）FT₃≥3.045pg/ml was a protective factor for OC reduction（OR=0.353,P<0.05）.（3）BMI≥24Kg/m²（OR=2.481,P<0.05）and TSH>4.74m IU/l（OR=2.012,P<0.05）were risk factors for dyslipidemia,and positive TPOAb was a protective factor for the occurrence of dyslipidemia（OR=0.222,P<0.05）.（4）BMI≥24Kg/m²（OR=2.647,P<0.05）,TSH>4.74m IU/l（OR=2.099,P<0.05）,and dyslipidemia（OR=3.003,P<0.05）was a risk factor for the development of HUA,and every 10 years of age increment was a protective factor（OR=0.425,P<0.05）.（5）every 10 years of age increment（OR=2.465,P<0.05）,BMI≥24 Kg/m²（OR=3.112,P<0.05）,dyslipidemia（OR=10.375,P<0.05）,and FT₃≥3.045 pg/ml within the normal reference range（OR=3.338,P<0.05）were risk factors for Ty G index increment.（6）BMI≥24 Kg/m²（OR=3.831,P<0.05）and dyslipidemia（OR=8.363,P<0.05）were risk factors for c AIP increment,and women were protective factors（OR=0.243,P<0.05）.（7）In the SCH group（1）FT₃≥3.045 pg/ml within the normal reference range was a protective factor for OC reduction（OR=0.140,P<0.05）.（2）Every 10 years of age increment（OR=2.490,P<0.05）and HUA（OR=5.410,P<0.05）were risk factors for dyslipidemia.（3）Female was a protective factor for HUA（OR=0.154,P<0.05）.（4）BMI≥24Kg/m²（OR=5.189,P<0.05）and dyslipidemia（OR=22.139,P<0.05）were risk factors for Ty G index increment.（5）BMI≥24Kg/m²（OR=7.284,P<0.05）and dyslipidemia（OR=17.496,P<0.05）were risk factors for c AIP increment.Conclusion（s）:（1）Patients with HT combined with SCH were more likely to have elevated lipid metabolism disorders（TG,TC,LDL-C）,elevated Ty G index and percentage,and elevated c AIP levels and percentage than patients with NT and HT with normal thyriod function.（2）No difference was seen in the OC level and the percentage of OC reduction in patients in the HT combined with SCH group compared with the NT group and the HT with normal thyriod function.（3）Each additional 10 years of age was a risk factor for OC reduction in all groups,and FT₃≥3.045 pg/ml in the normal range was a protective factor for OC reduction in the HT and SCH populations.