Feng Fen, Zhou Bin, Zhou Ci-La, Huang Ping, Wang Gang, Yao Kuang
School of Pharmacy, Shaoyang University, Shaoyang 422099, Hunan Province, China.
Department of Endocrinology, The Central Hospital of Shaoyang, Shaoyang 422099, Hunan Province, China.
World J Diabetes. 2024 Feb 15;15(2):209-219. doi: 10.4239/wjd.v15.i2.209.
Diabetes and thyroiditis are closely related. They occur in combination and cause significant damage to the body. There is no clear treatment for type-2 diabetes mellitus (T2DM) with Hashimoto's thyroiditis (HT). While single symptomatic drug treatment of the two diseases is less effective, combined drug treatment may improve efficacy.
To investigate the effect of a combination of vitamin D, selenium, and hypo-glycemic agents in T2DM with HT.
This retrospective study included 150 patients with T2DM and HT treated at The Central Hospital of Shaoyang from March 2020 to February 2023. Fifty patients were assigned to the control group, test group A, and test group B according to different treatment methods. The control group received low-iodine diet guidance and hypoglycemic drug treatment. Test group A received the control treatment plus vitamin D treatment. Test group B received the group A treatment plus selenium. Blood levels of markers of thyroid function [free T3 (FT3), thyroid stimulating hormone (TSH), free T4 (FT4)], autoantibodies [thyroid peroxidase antibody (TPOAB) and thyroid globulin antibody (TGAB)], blood lipid index [low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triacylglycerol (TG)], blood glucose index [fasting blood glucose (FBG), and hemoglobin A1c (HbA1c)] were measured pre-treatment and 3 and 6 months after treatment. The relationships between serum 25-hydroxyvitamin D3 [25 (OH) D3] level and each of these indices were analyzed.
The levels of 25 (OH) D, FT3 FT4, and LDL-C increased in the order of the control group, test group A, and test group B (all < 0.05). The TPOAB, TGAB, TC, TG, FBG, HbA1c, and TSH levels increased in the order of test groups B, A, and the control group (all < 0.05). All the above indices were compared after 3 and 6 months of treatment. Pre-treatment, there was no divergence in serum 25 (OH) D level, thyroid function-related indexes, autoantibodies level, blood glucose, and blood lipid index between the control group, test groups A and B (all > 0.05). The 25 (OH) D levels in test groups A and B were negatively correlated with FT4 and TGAB (all < 0.05).
The combination drug treatment for T2DM with HT significantly improved thyroid function, autoantibody, and blood glucose and lipid levels.
糖尿病与甲状腺炎密切相关。它们常合并发生，对身体造成严重损害。对于2型糖尿病（T2DM）合并桥本甲状腺炎（HT），目前尚无明确的治疗方法。虽然对这两种疾病进行单一的对症药物治疗效果较差，但联合药物治疗可能会提高疗效。
探讨维生素D、硒与降糖药物联合应用对T2DM合并HT的影响。
本回顾性研究纳入了2020年3月至2023年2月在邵阳市中心医院接受治疗的150例T2DM合并HT患者。根据不同治疗方法将50例患者分为对照组、试验组A和试验组B。对照组接受低碘饮食指导和降糖药物治疗。试验组A在对照组治疗基础上加用维生素D治疗。试验组B在试验组A治疗基础上加用硒。在治疗前、治疗后3个月和6个月测量甲状腺功能标志物[游离T3（FT3）、促甲状腺激素（TSH）、游离T4（FT4）]、自身抗体[甲状腺过氧化物酶抗体（TPOAB）和甲状腺球蛋白抗体（TGAB）]、血脂指标[低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）、三酰甘油（TG）]、血糖指标[空腹血糖（FBG）和糖化血红蛋白（HbA1c）]的血药浓度。分析血清25-羟维生素D3[25（OH）D3]水平与上述各指标之间的关系。
25（OH）D、FT3、FT4和LDL-C水平按对照组、试验组A、试验组B的顺序升高（均P<0.05）。TPOAB、TGAB、TC、TG、FBG、HbA1c和TSH水平按试验组B、A、对照组的顺序升高（均P<0.05）。上述所有指标在治疗3个月和6个月后进行比较。治疗前，对照组、试验组A和试验组B之间的血清25（OH）D水平、甲状腺功能相关指标、自身抗体水平、血糖和血脂指标无差异（均P>0.05）。试验组A和试验组B的25（OH）D水平与FT4和TGAB呈负相关（均P<0.05）。
T2DM合并HT的联合药物治疗显著改善了甲状腺功能、自身抗体以及血糖和血脂水平。
