Relationship Between Intracranial Artery Atherosclerosis And Subclinical Hypothyroidism In Elderly Patients With Type 2 Diabetes Mellitus

In our country, stroke is the second reason of death and that is also the first reason of disability. Stroke accounts for ischemic stroke about 20%~40%.Research shows,compared with ordinary people,the incidence of subclinical hypothyroidism were significantly elevated in patients with type 2 diabetes mellitus.Subclinical hypothyroidism is refers to the serum thyrotropin levels increased,but the levels of serum free thyroid hormone and free triiodothyronine were normal, and there is no obvious clinical symptoms in these patients. At present the majority of scholars believe that the continued presence of subclinical hypothyroidism may cause atherosclerosis,The report about relationship between subclinical hypothyroidism and intracranial atherosclerosis was rare.ObjectiveTo study the association between intracranial atherosclerosis and subclinical hypothyroidism in elder T2 DM patients. Compared the general condition and the serum biochemical indexes in subclinical hypothyroidism group and normal thyroid function in patientsMethodsFour hundred and four elderly T2 DM patients were divided into normal thyroid function group(n=291) and SCH group(n=113). Their general conditions and biochemical test findings about sex, age, smoking history, body mass index(BMI), three free iodine armour gland original glycine(FT3) and free thyroxine(FT4), thyroid stimulating hormone(TSH), diabetes duration, fasting plasma glucose(FPG), glycosylated hemoglobin(HbA1C), duration of hypertension, systolic blood pressure(SBP), diastolic blood pressure(DBP), total cholesterol(TC), triglyceride(TG), high-density lipoprotein cholesterol(HDL), low density lipoprotein cholesterol(LDL) and very low density lipoprotein(VLDL), lipoprotein a [Lp(a)], platelet(PLT), prothrombin time(PT), activated partial clotting enzyme live time(APTT), fibrinogen(FIB), D-dimer(D- D), c-reactive protein(CRP),uric acid(UA),and homocysteine(Hcy) were compared.With intracranial atherosclerosis Logistic correlation analysis for the dependent variable. TSH in subclinical hypothyroidism group > 10.0 uIU/mL for the tangent point is divided into two groups, comparing the difference between the two groups of clinical indicators, and analyze the correlation between TSH and various clinical indicators.ResultThe incidence of intracranial atherosclerosis, the proportion of female patients, the serum levels of total cholesterol(TC),triglyceride(TG), low density lipoprotein(LDL-C),lipoprotein(a), fibrinogen,CRP,uric acid and homocysteine were significantly higher while the serum levels of fasting blood glucose, high density lipoprotein cholesterol(HDL-C), and D-dimer were significantly lower in SCH group than in males of normal thyroid function group(P<0.05). Multivariate stepwise logistic regression analysis showed that advanced age, systolic blood pressure, high serum levels of TSH,LDL-C,fibrinogen,uric acid and homocysteine were independent of intracranial artery atherosclerosis risk factors(P<0.05).The serum TSH level was positively related with the serum levels of TC,TG, LDL-C,lipoprotein(a), fibrinogen,CRP,uric acid and homocysteine, and negatively correlated with the serum levels of HDL-C, fasting blood glucose, and D-dinner in elderly T2 DM patoents(P<0.05).ConclusionThe risk to develop intracranial atherosclerosis increases in elderly T2 DM patients with SCH. High serum TSH level is the independent risk factor for intracranial atherosclerosis in elder T2 DM patients. It may be by changing the blood lipid spectrum, inflammation factors, blood coagulation and fibrinolysis system and blood UA, Hcy and other affected artery atherosclerosis risk factors increases the risk of the crowd intracranial atherosclerosis occurred. Thyroid function in patients with type 2 diabetes is necessary on a regular basis to check, so that SCH and early diagnosis and intervention, so as to prevent and delay the occurrence and development of intracranial artery atherosclerosis. In patients with type 2 diabetes is necessary on a regular basis to check thyroid function for the purpose of early diagnosis and treatment, so as to prevent and delay the occurrence and development of large intracranial atherosclerosis.