1Department of Functional and Laboratory Diagnostics, I Horbachevsky Ternopil National Medical University, Ternopil, Ukraine; 2Department of Pediatrics N2, I Horbachevsky Ternopil National Medical University, Ternopil, Ukraine.
Acta Clin Croat. 2022 Feb;60(3):483-495. doi: 10.20471/acc.2021.60.03.20.
This study aimed to evaluate changes of the lipid panel data in patients with comorbid type 2 diabetes mellitus (T2DM) and subclinical hypothyroidism (SCH) and to identify the probable prognostic values of the lipid profile for macrovascular complication (MVC) development. The study included 370 patients presented with only T2DM and 30 patients suffering from both T2DM and SCH. Receiver operating characteristic (ROC) analysis was used to identify prognostically significant values of the lipid profile with the optimal ratio of sensitivity and specificity for MVC development. All lipid profile values in the patients with T2DM combined with SCH were significantly higher compared to those with only T2DM. At the same time, SCH + T2DM increased the risk of exceeding target levels of triglycerides by 2.9 times and HDL-C by 4.1 times. Analysis of lipid profile values according to macrovascular involvement showed that total cholesterol, LDL-C and non-HDL-C in patients with T2DM and SCH were significantly higher compared to those with only T2DM. The levels of triglycerides >1.65 mmol/L, non-HDL-C >3.74 mmol/L and remnant cholesterol >0.74 mmol/L determined by the ROC analysis can be used for stratification of patients with T2DM combined with SCH into the category of increased risk of MVC development.
本研究旨在评估合并亚临床甲状腺功能减退症（SCH）的 2 型糖尿病（T2DM）患者的血脂谱数据变化，并确定血脂特征对大血管并发症（MVC）发展的可能预后价值。该研究纳入了 370 名仅患有 T2DM 的患者和 30 名同时患有 T2DM 和 SCH 的患者。采用受试者工作特征（ROC）分析确定血脂谱对 MVC 发展具有预后意义的显著值，以获得最佳的敏感性和特异性比值。与仅患有 T2DM 的患者相比，合并 SCH 的 T2DM 患者的所有血脂谱值均显著升高。同时，SCH+T2DM 使甘油三酯和 HDL-C 超过目标水平的风险分别增加了 2.9 倍和 4.1 倍。根据大血管受累情况对血脂谱值进行分析显示，合并 SCH 的 T2DM 患者的总胆固醇、LDL-C 和非 HDL-C 明显高于仅患有 T2DM 的患者。ROC 分析确定的甘油三酯＞1.65mmol/L、非 HDL-C＞3.74mmol/L 和残余胆固醇＞0.74mmol/L 水平可用于将合并 SCH 的 T2DM 患者分层为 MVC 发展风险增加的类别。
