Du Jing, Zhao Xin, Xu Xiumei, Zhang Zhichao, Zhang Xiaomei
Department of Endocrinology and Metabolism, Peking University International Hospital, Beijing, People's Republic of China.
Diabetes Metab Syndr Obes. 2023 Oct 12;16:3163-3171. doi: 10.2147/DMSO.S429941. eCollection 2023.
To explore the association between thyroid parameters and subclinical atherosclerosis (AS) in hospitalised euthyroid patients with type 2 diabetes mellitus (T2DM).
A retrospective analysis was conducted involving 1245 inpatients with T2DM. Free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) levels were measured, and carotid artery ultrasonography was performed. Thyroid hormone (TH) sensitivity was evaluated using thyroid feedback quantile-based index (TFQI), TSH index (TSHI), thyrotropin thyroxine resistance index (TT4RI), and free triiodothyronine/free thyroxine ratio (FT3/FT4).
In inpatients with T2DM having normal thyroid function, the incidence of subclinical AS declined with increasing levels of FT3, FT4, and FT3/FT4 ( < 0.05). Logistic regression analysis revealed that FT4 (OR, 0.914; 95% CI, 0.845-0.989), FT3 (OR, 0.374; 95% CI, 0.277-0.504), and FT3/FT4 (OR, 0.036; 95% CI, 0.013-0.061) were independently associated with subclinical AS ( < 0.05). However, TSH, TFQI, TSHI, and TT4RI levels were not associated with subclinical AS ( > 0.05). FT3/FT4 demonstrated superior predictive accuracy for subclinical AS than that of FT3 or FT4 alone ( < 0.001), with a cutoff point of 0.25.
In euthyroid inpatients with T2DM, subclinical AS exhibited negative correlation with FT3, FT4, and FT3/FT4 levels, independent of other risk factors for AS. Additionally, FT3/FT4 ratio had a good predictive value for subclinical AS.
探讨住院的甲状腺功能正常的2型糖尿病（T2DM）患者甲状腺参数与亚临床动脉粥样硬化（AS）之间的关联。
对1245例T2DM住院患者进行回顾性分析。检测游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）和促甲状腺激素（TSH）水平，并进行颈动脉超声检查。使用基于甲状腺反馈分位数的指数（TFQI）、TSH指数（TSHI）、促甲状腺素甲状腺素抵抗指数（TT4RI）和游离三碘甲状腺原氨酸/游离甲状腺素比值（FT3/FT4）评估甲状腺激素（TH）敏感性。
在甲状腺功能正常的T2DM住院患者中，亚临床AS的发生率随FT3、FT4和FT3/FT4水平的升高而降低（P<0.05）。逻辑回归分析显示，FT4（比值比[OR]，0.914；95%置信区间[CI]，0.845 - 0.989）、FT3（OR，0.374；95%CI，0.277 - 0.504）和FT3/FT4（OR，0.036；95%CI，0.013 - 0.
