Clinical Analysis Of Subclinical Hypothyroidism And Type 2 Diabetic Microvascular Complications

Background:With the change of people’s lifestyle and eating habits,SCH has become the highest prevalence of thyroid metabolic disorders in China.Because of the mild disease symptoms,it has been ignored for so long.But in recent years,more and more people have paid great attentions to its extensive influence.Studies show that it is associated with a variety of metabolic disorders,such as T2DM,and it is most closely related to the microvascular complications of T2DM.Nowadays,the correlation between SCH and T2DM microvascular complications has become a hot research topic at home and abroad,but the specific conclusions have not yet reached a broad consensus.Objective:The objectives are mproving the awareness rate of SCH,and exploring the correlation between SCH and T2DM microvascular complications,and searching for the risk factors that may exist of T2DM microvascular complications to find a new direction and provide a new theoretical basis for the prevention and treatment of diabetic microvascular complications.Methods:1.To selecte 260 Type 2 diabetic patients who were hospitalized from department of Endocrinology,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui Province,China.,during May 2014 to January 2015.Exclusion of other interfering diseases,The remaining were 245 cases。Among them,112 cases were female and 133 were male,and average age was(13.6±55.9)years.2.According to whether with subclinical hypothyroidism,patients were divided into type 2 diabetic patients with subclinical hypothyroidism(37),type 2 diabetes group(208 people).3.Counted general information of statistical research objects:age,duration of diabetes,measurement of height,weight,calculation of body mass index(BMI),random admission blood pressure.4.Determination of clinical parameters glycosylated hemoglobin(HbA1c),total cholesterol,triglycerides,uric acid,creatinine,thyroid function,high density lipoprotein cholesterol(HDL-C),low density lipoprotein(LDLC),C reactive protein(CRP),1,25 hydroxyvitamin D3,osteocalcin,24 hour urinary albumin(UAER).5.Filled in the questionnaire of diabetic peripheral neuropathy(DPN).6.Be levothyroxine replacement therapy on subclinical hypothyroidism patients whose TSH>10(mIU/L).The data were statistically analyzed.The numerical changes of related indexes were observed and followed up.And to explored the subclinical hypothyroidism and type 2 diabetic micro vascular complications of correlation.After the replacement therapy,the development of diabetic complications.Result:1.The subjects,subclinical hypothyroidism accounted for 37 cases,all patients with type 2 diabetes mellitus 15.1%.2.In the general information,patients with subclinical hypothyroidism group and simple type 2 diabetes mellitus group compared,body mass index,systolic blood pressure numerical value,incidence of hypertension was higher,the difference is statistically significant(P<0.05).3.Clinical indicators,with subclinical hypothyroidism group and simple type 2 diabetes mellitus group compared,blood creatinine,total cholesterol.Serum levels of Pro thyroid hormone,24 hours urine micro albumin index increased significantly,the difference is statistically significant(P<0.05).4.With subclinical hypothyroidism in patients with type 2 diabetes mellitus and simple type 2 diabetes compared with patients,diabetic nephropathy,diabetic retinopathy incidence increased significantly,the difference is statistically significant,between the two groups of diabetic peripheral neuropathy occurred rate had no significant difference.5.TSH is an independent risk factor for diabetic nephropathy(P<0.05,OR=1.012).6.After the replacement treatment with small dose of Euthyrox,the BMI,Scr and UAER values of some patients were decreased.But for patients with diabetic nephropathy in Ⅳ phase and beyond,even the replacement therapy can not improve the development of the disease.Conclusion:1.With subclinical hypothyroidism in patients with type 2 diabetes mellitus and simple type 2 diabetes compared with patients,diabetic nephropathy,incidence increased significantly。SCH is an independent risk factor for diabetic renal complications,and it affects multiple metabolic indicators of T2DM.2.After the replacement treatment with small dose of Euthyrox,T2DM patients with SCH may delay the development of its renal complications.But for patients with diabetic nephropathy Ⅳ stage and more seriously,even if the replacement therapy,which still can not improve the development of the disease.