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| Clinical characteristics of patients with diabetes mellitus combined with hashimoto thyroiditis and effects of thyroid autoimmunity on islet function |
| FANG Yuan ZHANG Yuanyuan YUAN Shasha YU Caiguo ZHANG Baoyu YANG Longyan▲ |
| Endocrine Metabolism and Immunization Center, Luhe Hospital, Capital Medical University, Beijing 101149, China |
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Abstract Objective To investigate the clinical features of patients with type 2 diabetes mellitus (T2DM) combined with hashimoto thyroiditis and the effects of thyroid autoimmune status on islet function in T2DM. Methods A retrospective case-control study was conducted on 758 patients with type 2 diabetes admitted to the Department of Endocrinology, Beijing Luhe Hospital Affiliated to Capital Medical University from August 2015 to December 2016. General data such as gender and age, as well as related indicators such as thyroid function, biochemistry and islet function, were collected. Patients were divided into type 2 diabetes mellitus combined with hashimoto thyroiditis group and type 2 diabetes mellitus group according to the levels of antibody A-TPO, A-TG associated with hashimoto thyroiditis, and the differences in clinical characteristics between the two groups were compared. The patients were further divided into the group with low C-peptide level and the group with high C-peptide level. Univariate analysis was performed to identify the factors that might affect the C-peptide level, and multivariate Logistic regression analysis was performed to verify that hashimoto thyroiditis was an independent risk factor for islet dysfunction. Results There were 227 patients with type 2 diabetes mellitus combined with hashimoto thyroiditis and 531 patients with type 2 diabetes mellitus only. Compared with the simple type 2 diabetes group, the diastolic blood pressure increased, the waist-hip ratio decreased, the level of C-peptide 2 h decreased, and the serum creatinine decreased in the type 2 diabetes mellitus combined with hashimoto thyroiditis group, and the difference was statistically significant (P ＜ 0.05). C peptide 0 h and uric acid levels decreased, and the proportion of women increased, the difference was highly statistically significant (P ＜ 0.01). Univariate analysis showed that age, diabetes course, body mass index, waist circumference, glycosylated hemoglobin (HbA1c), fasting blood glucose (FPG), creatinine, uric acid, triglyceride, low-density lipoprotein cholesterol (HDL-C), coronary heart disease, and hashibon thyroiditis were confactors affecting C-peptide level (P ＜ 0.05). Multivariate Logistic regression analysis showed that hashimoto thyroiditis was an independent risk factor for islet dysfunction in type 2 diabetes patients (OR = 1.887, 95%CI, 1.256-2.835, P = 0.002), and the course of diabetes, HbA1c, FPG and HDL-C were also independent risk factors. Conclusion Compared with patients with type 2 diabetes mellitus combined with hashimoto thyroiditis, patients with type 2 diabetes mellitus have poor islet function, and hashimoto thyroiditis is an independent risk factor for poor islet function in patients with type 2 diabetes mellitus.
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