Effect Of Thyroid Function And Hypothyroidism On Chronic Complications And Complications Of Diabetes Mellitus In Type 2 Diabetic Patients

Objectve:1 To investigate the thyroid function of patients with type 2 diabetes mellitus in hospital, and the effect of hypothyroidism、Subclinical hypothyroidism function on chronic complications of type 2 diabetes.2 To explore whether Subclinical hypothyroidism are risk factors for chronic complications of type 2 diabetes, and to Provid theoretical basis for further treatment.Methods:4297patients administrated in the first affiliated hospital of kunming medical university diabetes division from October 2009 to May 2014 were included in this study, All patients were diagnosed as T2DM according to the WHO 1999 criteria. TSH, FT3, FT4, gender, age, duration of the disease, body mass index (BMI), blood pressure (BP), Second day of admission fasting blood fasting venous blood glucose (FPG), glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), serum creatinine and urea nitrogen. Urinary albumin creatinine ratio,prevalence of thyroid diseases and thyroid ultrasound performance were analyzed retrospectively. According to their thyroid function, patients were divided into3 groups(53 hypothyroidism 187 Subclinical hypothyroidism and 212 euthyroidism function).General biochemical indicators and incidence of diabetic chronic complications were compared among 3 groups.Resules:1) According to their thyroid function:all patients were divided into 3832 cases(89.18%) of euthyroidism (including 231 cases of hashimoto’s thyroiditis); 41 cases (0.96%)of hyperthyroidism (22 cases with hashimoto’s thyroiditis and hyperthyroidism);21 cases of subclinical hyperthyroidism (0.49%); hypothyroidism 98 cases (2.28%) (31 cases of hashimoto’s thyroiditis hypothyroidism).305 cases (7.10%)of subclinical hypothyroidism.2)Thyroid ultrasound:3179 cases with nodular goiter, prevalence of 74%.301 cases of hashimoto’s thyroiditis, prevalence was 7.00%.158 cases of thyroid cancer, prevalence was 3.67%.659 cases of normal thyroid ultrasound examination, accounted for 15.33%.3)According to their thyroid function,cases with normal thyroid ultrasound examination were subdivided into 3 groups:euthyroidism (212 cases), subclinical hypothyroidism (187 cases), hypothyroidism (53 cases).Age, total cholesterol, low-density lipoprotein cholesterol, TSH, Urinary albumin creatinine ratio of subclinical hypothyroidism group were different among 3 groups (P<0.05).Prevalence of coronary heart disease in euthyroidism, subclinical hypothyroidism and hypothyroidism group were7/212,15/187 and 6/53, respectively, significant difference were found(P< 0.05); Prevalence of Diabetic nephropathy in euthyroidism, subclinical hypothyroidism and hypothyroidism group were 25/212,82/187,27/53, respectively, significance difference were found(P< 0.05).No significance differences of hypertension, atherosclerosis, incidence of diabetic retinopathy, diabetic peripheral neuropathy were found among 3 groups (P> 0.05).4) Multviariable Logistic regression analysis suggested subclinical hypothyroidism is one of the risk factors for coronary heart disease and early onset of diabetic nephropathy (OR values were 2.109 and3.306,respectively)Conclusion:in Patients with type 2 diabetes, Hospitalized patients with type 2 diabetes (1) most cases (89.18%)had normal thyroid function. The commonest thyroid dysfunction was subclinical hypothyroidism (7.10%), followed by hypothyroidism (2.28%).The third is hyperthyroidism(0.96%).2)Prevalence of thyroid nodular goiter was 74% and it is the commonest abnormal thyroid ultrasound founding.Followed by hashimoto’s thyroiditis, the third is thyroid cancer. Normal thyroid ultrasound was 15.33%.3) In cases with normal thyroid ultrasound, age, total cholesterol, triglyceride, low density lipoprotein cholesterol, TSH, urinary albumin creatinine ratio, insulin resistance index were different among subclinical hypothyroidism, hypothyroidism and euthyroidism group. No differences were found so as to blood pressure,duration of diabetes, BMI, fasting glucose, glycosylated hemoglobin among 3 groups. Prevalence of coronary heart disease and diabetic kidney disease were higher in Subclinical hypothyroidism and hypothyroidism group than that of is euthyroidism group.4) multivariable Logistic regression analysis suggested that hypothyroidism is one of the risk factors for coronary heart disease and diabetic nephropathy.