Xu Yiqi, Dong Biwu, Tang Youyun, Jiang Yan, Huang Tingting, Jiang Feng, Xing Wei, Chen Junsheng, Zhu Fengping
Department of Endocrinology and Genetic Metabolism, The First Affiliated Hospital of Anhui Health College (the Second People's Hospital of Chizhou), Chizhou, Anhui, China.
Department of Cardiology, The First Affiliated Hospital of Anhui Health College (the Second People's Hospital of Chizhou), Chizhou, Anhui, China.
BMC Endocr Disord. 2025 Apr 21;25(1):106. doi: 10.1186/s12902-025-01928-x.
The association between thyroid-stimulating hormone (TSH) and type 2 diabetes mellitus (T2DM) is well known. However, whether TSH is related to nonproliferative diabetic retinopathy (NPDR) has not been studied. This study aimed to explore the relationship between TSH and NPDR in Chinese patients with T2DM.
In this cross-sectional study, 427 patients with T2DM were enrolled. The individuals were classified into two groups according to the fundus oculi examination: the non-diabetic retinopathy (NDR) group (n = 224) and the non-proliferative diabetic retinopathy (NPDR) group (n = 203). The individuals' demographic and clinical data were collected by reviewing medical records and direct interviews. The demographic data and biochemical parameters were compared between groups using the Student's t - test or the Mann‒Whitney U test, anthropometric measurements, thyroid function, and NPDR were evaluated, and the associations between TSH and NPDR were assessed using logistic regression models.
No significant differences in age, sex, body mass index (BMI), incidence of alcohol consumption, and duration of diabetes were found between these two groups. The systolic blood pressure (SBP), incidence of smoking, TSH, blood urea nitrogen (BUN), and urinary micro-albumin (mALB) were significantly higher in the NPDR group than in the NDR group (P < 0.05). Individuals in the NDR group had higher levels of thyroxine (T4), glutamic pyruvic transaminase (ALT), fasting C-peptide (FCP), and 2-hour C-peptide (2hCP) than individuals in the NPDR group (P < 0.05). Spearman's correlation analysis revealed that the serum TSH levels were negatively associated with the HbA1c levels in all patients (r=-0.11, P < 0.05). Serum TSH levels were negatively correlated with HbA1c levels (r = -0.19, P < 0.01) and positively correlated with diabetes duration (r = 0.14, P < 0.05) in the NPDR group. Multivariate logistic regression analysis revealed that high TSH levels, sex, diabetes duration, high-density lipoprotein cholesterol (HDL-C), glycosylated hemoglobin (HbA1c), FCP, and SBP were associated with NPDR [odds ratio (OR) > 1, P < 0.05]. Receiver operating characteristic curve analysis revealed that the optimal cutoff point of TSH for predicting NPDR was 2.235 mIU/L.
The TSH level is independently associated with NPDR in the Chinese population with T2DM. A high serum TSH level may be a potential risk factor for NPDR and an indicator for screening for diabetic microangiopathy.
This study is registered with the Chinese Clinical Trial Registry (02/21/2025 ChiCTR2500097614).
促甲状腺激素（TSH）与2型糖尿病（T2DM）之间的关联已广为人知。然而，TSH是否与非增殖性糖尿病视网膜病变（NPDR）相关尚未得到研究。本研究旨在探讨中国T2DM患者中TSH与NPDR之间的关系。
在这项横断面研究中，纳入了427例T2DM患者。根据眼底检查将个体分为两组：非糖尿病视网膜病变（NDR）组（n = 224）和非增殖性糖尿病视网膜病变（NPDR）组（n = 203）。通过查阅病历和直接访谈收集个体的人口统计学和临床数据。使用Student's t检验或Mann-Whitney U检验比较两组之间的人口统计学数据和生化参数，评估人体测量指标、甲状腺功能和NPDR，并使用逻辑回归模型评估TSH与NPDR之间的关联。
两组在年龄、性别、体重指数（BMI）、饮酒发生率和糖尿病病程方面未发现显著差异。NPDR组的收缩压（SBP）、吸烟发生率、TSH、血尿素氮（BUN）和尿微量白蛋白（mALB）显著高于NDR组（P < 0.05）。NDR组个体的甲状腺素（T4）、谷丙转氨酶（ALT）、空腹C肽（FCP）和2小时C肽（2hCP）水平高于NPDR组个体（P < 0.05）。Spearman相关性分析显示，所有患者的血清TSH水平与糖化血红蛋白（HbA1c）水平呈负相关（r = -0.11，P < 0.05）。NPDR组中，血清TSH水平与HbA1c水平呈负相关（r = -0.19，P < 0.01），与糖尿病病程呈正相关（r = 0.14，P < 0.05）。多因素逻辑回归分析显示，高TSH水平、性别、糖尿病病程、高密度脂蛋白胆固醇（HDL-C）、糖化血红蛋白（HbA1c）、FCP和SBP与NPDR相关[比值比（OR）> 1，P < 0.05]。受试者工作特征曲线分析显示，预测NPDR的TSH最佳截断点为2.235 mIU/L。
在中国T2DM人群中，TSH水平与NPDR独立相关。高血清TSH水平可能是NPDR的潜在危险因素和糖尿病微血管病变筛查的指标。
本研究已在中国临床试验注册中心注册（2025年2月21日，ChiCTR2500097614）。
