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合并甲状腺功能障碍的2型糖尿病患者血脂谱数据对大血管并发症发生的预后价值

PROGNOSTIC VALUES OF LIPID PANEL DATA FOR MACROVASCULAR COMPLICATION DEVELOPMENT IN TYPE 2 DIABETIC PATIENTS WITH COMORBID THYROID DYSFUNCTION.

作者信息

Marushchak Mariya, Krynytska Inna, Gashynska Olena, Yakymchuk Olena

机构信息

Department of Functional and Laboratory Diagnostics, I Horbachevsky Ternopil National Medical University, Ternopil, Ukraine.

Department of Medical Prevention Disciplines and Laboratory Diagnostics, Rivne Medical Academy, Rivne, Ukraine.

出版信息

Acta Clin Croat. 2024 Apr;63(1):89-100. doi: 10.20471/acc.2024.63.01.11.

Abstract

This study aimed to evaluate prognostic values of the serum lipid panel data for development of macrovascular complications (MVC) in patients with type 2 diabetes mellitus (T2DM) alone and those with comorbid hypothyroidism (HT), diffuse non-toxic goiter (DNTG), or a combination of these disorders. The study included 596 inpatients. Receiver operating characteristic (ROC) analysis was used to identify prognostically significant values of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), non-HDL-cholesterol (non-HDL-C) and remnant cholesterol (RC). The following cut-off points that determine the relative risk of MVC development were established: TC >5.11 mmol/L, TG ≥2.03 mmol/L, LDL-C ≥2.97 mmol/L and non-HDL-C ≥4.29 mmol/L in T2DM patients with comorbid HT; TC ≥4.97 mmol/L, TG ≥2.54 mmol/L, LDL-C ≥3.21 mmol/L and non-HDL-C ≥4.20 mmol/L in T2DM patients with comorbid DNTG; and TC ≥4.89 mmol/L, TG ≥1.56 mmol/L, LDL-C ≥2.93 mmol/L, non-HDL-C ≥4.04 mmol/L and RC ≥1.14 mmol/L in those with comorbid HT and DNTG. Thus, serum levels of TC, TG, LDL-C, non-HDL-C and RC can be used for stratification of T2DM patients with comorbid thyroid dysfunction into the category of increased risk of MVC development.

摘要

本研究旨在评估血清脂质谱数据对单纯2型糖尿病(T2DM)患者以及合并甲状腺功能减退症(HT)、弥漫性非毒性甲状腺肿(DNTG)或这些疾病组合的患者发生大血管并发症(MVC)的预后价值。该研究纳入了596名住院患者。采用受试者工作特征(ROC)分析来确定总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、非高密度脂蛋白胆固醇(non-HDL-C)和残余胆固醇(RC)的预后显著值。确定了以下决定MVC发生相对风险的截断点:合并HT的T2DM患者中,TC>5.11 mmol/L、TG≥2.03 mmol/L、LDL-C≥2.97 mmol/L和non-HDL-C≥4.29 mmol/L;合并DNTG的T2DM患者中,TC≥4.97 mmol/L、TG≥2.54 mmol/L、LDL-C≥3.21 mmol/L和non-HDL-C≥4.20 mmol/L;合并HT和DNTG的患者中,TC≥4.89 mmol/L、TG≥1.56 mmol/L、LDL-C≥2.93 mmol/L、non-HDL-C≥4.04 mmol/L和RC≥1.14 mmol/L。因此,TC、TG、LDL-C、non-HDL-C和RC的血清水平可用于将合并甲状腺功能障碍的T2DM患者分层为MVC发生风险增加的类别。

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Hyperlipidemia and hypothyroidism.高脂血症与甲状腺功能减退症。
Clin Chim Acta. 2022 Feb 15;527:61-70. doi: 10.1016/j.cca.2022.01.006. Epub 2022 Jan 14.

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