Clinical significance of serum homocysteine on peripheral vascular plaque in type 2 diabetes mellitus with subclinical hypothyroidism / 中国医师杂志

ABSTRACT

Objective:To investigate the effect of homocysteine (Hcy) on peripheral vascular plaque formation in patients with type 2 diabetes mellitus (T2DM) combine subclinical hypothyroidism (SCH), and to provide guidance for clinical medication and prognosis judgement.Methods:A total of 125 patients with type 2 diabetes admitted to the NO.3201 Hospital from 2018 Jan to Dec 2019 were selected. 125 patients with type 2 diabetes mellitus were divided into T2DM without plaque group (40 cases), plaque group (23 cases), T2DM with SCH without plaque group (25 cases) and plaque group (37 cases) according to thyroid function and whether they had peripheral vascular plaque. Data were collected to analyze the influencing factors of peripheral vascular disease.Results:(1) The incidence of vascular plaque in T2DM group and T2DM with SCH group was 36.5%(23/63) and 59.7%(37/62), respectively, with significant difference ( P<0.05). (2) There were significant differences in serum thyroid stimulating hormone (TSH), apolipoprotein A (ApoA), triglyceride (TG) and Hcy between T2DM group and T2DM with SCH group ( P<0.05); there was significant difference in low-density lipoprotein (LDL-C) and Hcy between T2DM groups with or without plaque ( P<0.05); there were significant differences in ApoA and Hcy between T2DM with SCH group with or without plaque ( P<0.05). (3) Logistic regression analysis showed that Hcy was the risk factors for the occurrence of vascular plaque in T2DM and T2DM with SCH group ( OR=1.640, 2.695, P<0.05). (4) Receiver operating characteristic (ROC) curve showed that the area under the curve of Hcy in T2DM group was 0.842 and Youden index was 15.75 μmol/L; The Hcy's area under ROC curve was 0.945 and Youden index was 12.9 μmol/L in T2DM with SCH. Conclusions:Hcy is closely related to the presence of peripheral vascular plaque in T2DM patients with subclinical hypothyroidism. The detection of blood Hcy level can provide new ideas for early diagnosis and treatment of peripheral vascular lesions in T2DM patients with SCH.