| Objective: By comparing the changes of clotting related indicators in patients with type 2 diabetes mellitus(T2DM)complicated with the different severity of hypothyroidism,we investigate the effects of different severity of hypothyroidism on blood coagulation state,providing a reference for the clinical diagnosis and treatment of such patients,to prevent early target organ damage and thrombosis or bleeding events caused by abnormal coagulation.Methods: From November 2018 to November 2019 in Affiliated Hospital of Qinghai University,T2 DM combined with hypothyroidism were selected as the observation group,from the department of general medicine,department of geriatric medicine,department of endocrinology.According to the thyroid function level,the observation group was divided into mild subclinical hypothyroidism(SCH)group(n=50),severe SCH group(n=45),overt hypothyroidism(OH)group(n=35),and 50 cases of T2 DM with normal thyroid function at the same time were selected as the control group(n=50).1.completed the statistical analysis of the basic situation of enrolled patients;2.compared and analyzed the coagulation parameters(APTT,PT,TT,FIB,DD,FDP,AT-III)and platelet parameters(PLT,PCT,MPV,PDW);3.completed the correlation analysis between TSH,FT3,FT4 and coagulation indicators.Results: 1.Basic data: the general data of age,gender,smoking history,drinking history,duration of diabetes,BMI,fasting plasma glucose,2h postprandial glucose,fasting c-peptide among the four groups were compared,with no statistical difference(P>0.05).2.Thyroid hormone indexes: there were statistically significant differences in serum TSH,FT3,FT4,and TPO-Ab of the four groups(P<0.05);3.Coagulation parameters: DD,FIB,FDP,AT-III were statistically different among the four groups(P<0.05),After comparing between two groups,FIB in the severe SCH group and the OH group was higher than that in the normal thyroid function group.FDP,DD in the OH group were higher than those in the normal thyroid function group.The level of AT-III in the severe SCH group and the OH group was lower than that in the normal thyroid function group,and lower than that in the mild SCH group(P<0.05).APTT,PT,and TT in the four groups were compared,with no statistical difference(P>0.05).4.Platelet parameters: MPV and PDW were statistically different among the four groups,pair comparison showed that MPV in the normal group was lower than that in another three groups,and MPV in the severe SCH group and the OH group was higher than that in the mild SCH group.PDW of the severe SCH group was higher than that of the normal thyroid function group,and PDW in the OH group was higher than that in the normal thyroid function group and the mild SCH group,showing a statistical difference(P<0.05).PLT,PCT among these four groups were compared,with no statistical difference(P>0.05).5.Correlation analysis showed that FT3 was negatively correlated with FDP,DD,rs =-0.291,-0.297;FT4 was positively correlated with ATIII,rs =0.245,and negatively correlated with FDP,DD,MPV,and PDW,rs =-0.299,-0.249,-0.249,-0.191;TSH was positively correlated with FDP,FIB,DD,MPV,PDW,rs =0.313,0.257,0.280,0.381,0.302,and negatively correlated with ATIII,rs =-0.231.Conclusions: 1.Coagulation indicators: FIB increased and AT-III decreased in patients with severe SCH,while FIB,DD,and FDP increased and AT-III decreased in patients with OH.It suggested that compared with T2 DM patients alone,the blood of patients with severe SCH was relatively high in coagulation,and the patients with OH might have a tendency of hyperfibrinolysis secondary to high coagulation.2.Platelet parameters: MPV increased in patients with mild SCH,while MPV and PDW increased in patients with severe SCH and OH.The heavier the degree of hypothyroidism,the higher the MPV,PDW.3.There were correlations between FT3,FT4,TSH,and coagulation index in T2 DM patients,The more severe of the hypothyroidism,the more obvious of the abnormality of clotting related indicators.In patients with T2 DM combined with hypothyroidism,while being treated for their primary disease,changes in coagulation and platelet indexes should be monitored to avoid serious vascular complications. |
