Correlation Between 25-dihydroxyvitamin D And Thyroid Nodules In Patients With T2DM

Objective:To compare serum 25-hydroxylvitamin D [25(OH)D] level in patients with Type 2 diabetes mellitus(T2DM)combined with thyroid nodule(TN)and without TN,and to analyze the correlation between serum 25(OH)D level and TN in patients with T2 DM.Datas and methods:Datas:The clinical data of 581 T2 DM patients hospitalized in the Department of geriatric endocrinology of Xiangya Hospital of Central South University from September 2019 to September 2021 were collected.There were 397 T2 DM patients with TN(DTN group)and 184 T2 DM patients without TN(DM group).The clinical data of 208 healthy subjects(HC group)without T2 DM and TN were collected.methods:(1)The general data and laboratory indexes of total DM group and HC group were compared.(2)The general data and laboratory indexes of DTN group and simple DM group were compared.(3)581 T2 DM patients were divided into vitamin D deficiency group(<10ng/ml),vitamin D insufficiency group(10～29.9ng/ml)and vitamin D sufficiency group(≥30ng/ml)according to vitamin D level.The general data and laboratory indexes of the above three groups were compared respectively.(4)397 patients in DTN group were divided into vitamin D deficiency group(<10ng/ml),vitamin D insufficiency group(10～29.9ng/ml)and vitamin D sufficiency group(≥ 30ng/ml).The ultrasonic characteristics(TI-RADS grade)of TN in the above three groups were compared respectively.(5)Spearman correlation analysis was used to test the correlation between serum 25(OH)D and other related biochemical indexes in patients with T2 DM.(6)Univariate and multivariate logistic regression analysis was used to analyze the risk factors of TN in T2 DM patients.Results:1.The level of 25(OH)D in total DM group was significantly lower than that in HC group;Compared with simple DM group,the level of 25(OH)D in DTN group was lower(P<0.05).2.In T2 DM patients,the prevalence of TN in vitamin D deficiency group,vitamin D insufficiency group and vitamin D sufficiency group decreased successively(78.46%,69.43% and 54.32% respectively)(all P<0.05).3.In DTN group,the proportion of TN in patients with sufficient vitamin D was the lowest,and the proportion of TI-RADS class 2 nodules was significantly higher than that in patients with insufficiency and deficiency of vitamin D,while the proportion of class 3,4 and 5 nodules was significantly lower than that in patients with insufficiency and deficiency of vitamin D(all P<0.05).4.In Spearman correlation analysis,25(OH)D in T2 DM patients was negatively correlated with fasting blood glucose and positively correlated with free thyroxine and high density lipoprotein(P<0.05).5.Univariate and multivariate logistic regression analysis showed that age,female,2h postprandial blood glucose,glycosylated hemoglobin and low vitamin D level were the risk factors of TN in T2 DM patients.Conclusion:1.The vitamin D level of T2 DM patients was significantly lower than that of healthy people without T2 DM and TN.2.The vitamin D level of T2 DM patients with TN is lower than that of T2 DM patients without TN.low level of 25(OH)D is the independent risk factors of TN in T2 DM patients.