He Weilei, Pang Chunyang, Chen Luowei, Zeng Yaying, Gao Lingfei, Huang Huanjie, Zhang Wanli, Wang Xun, Deng Binbin
Department of Nuclear Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Muscle Nerve. 2022 Dec;66(6):723-729. doi: 10.1002/mus.27719. Epub 2022 Sep 23.
INTRODUCTION/AIMS: Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications of diabetes mellitus. Diabetic patients often have thyroid dysfunction. The aim of this study was to investigate the association between low triiodothyronine (T3) syndrome and DPN in patients with type 2 diabetes mellitus (T2DM).
A retrospective review was performed of 928 patients with T2DM for whom data was available for clinical manifestations and nerve conduction studies (NCS), and of 134 non-diabetic controls. The composite Z scores of conduction velocity and amplitude were calculated. Low T3 syndrome was defined as T3 levels below the lower limit of the reference interval.
Among the patients with T2DM, 632 (68.1%) had DPN, and a larger proportion of these patients presented with low T3 syndrome than patients without DPN. After adjusting for potential confounders, low T3 syndrome was independently associated with the occurrence of DPN (odds ratio [OR] = 2.049, 95% confidence interval [CI] 1.319-3.181, p = .001) and the severity of DPN (OR = 1.597, 95% CI 1.030-2.476, p = .036). Adding the criterion of low T3 syndrome improved the prognostic performance of the traditional model (age + gender + diabetic duration + glycated hemoglobin [HbA1c]) for predicting DPN.
Low T3 syndrome is associated with a higher risk and increased severity of DPN in patients with T2DM. These findings suggest that low T3 syndrome could be a predictor for risk stratification in patients with T2DM.
引言/目的：糖尿病周围神经病变（DPN）是糖尿病最常见的慢性并发症之一。糖尿病患者常伴有甲状腺功能障碍。本研究旨在探讨2型糖尿病（T2DM）患者低三碘甲状腺原氨酸（T3）综合征与DPN之间的关联。
对928例有临床表现和神经传导研究（NCS）数据的T2DM患者以及134例非糖尿病对照进行回顾性分析。计算传导速度和波幅的综合Z评分。低T3综合征定义为T3水平低于参考区间下限。
在T2DM患者中，632例（68.1%）患有DPN，与无DPN的患者相比，这些患者中出现低T3综合征的比例更高。在调整潜在混杂因素后，低T3综合征与DPN的发生独立相关（比值比[OR]=2.049，95%置信区间[CI]1.319 - 3.181，p = 0.001）以及DPN的严重程度（OR = 1.597，95% CI 1.030 - 2.476，p = 0.036）。加入低T3综合征标准可提高传统模型（年龄+性别+糖尿病病程+糖化血红蛋白[HbA1c]）预测DPN的预后性能。
低T3综合征与T2DM患者发生DPN的风险较高及严重程度增加相关。这些发现表明低T3综合征可能是T2DM患者风险分层的一个预测指标。
