Association between Subclinical Hypothyroidism and Cardiac Autonomic Neuropathy in Type 2 Diabetes Mellitus
BackgroundCardiac autonomic neuropathy (CAN) is a common and severe chronic diabetic complication, whose association with thyroid function has rarely been reported.ObjectiveTo investigate the association between subclinical hypothyroidism and CAN in type 2 diabetes mellitus (T2DM) .MethodsWe perform...
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| Format: | Article |
| Language: | zho |
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Chinese General Practice Publishing House Co., Ltd
2022-03-01
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| Series: | Zhongguo quanke yixue |
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| Online Access: | https://www.chinagp.net/fileup/1007-9572/PDF/yx2021123110.pdf |
| _version_ | 1811153560055840768 |
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| author | ZHAO Lei, LI Ruqiang, YUAN Mingxia |
| author_facet | ZHAO Lei, LI Ruqiang, YUAN Mingxia |
| author_sort | ZHAO Lei, LI Ruqiang, YUAN Mingxia |
| collection | DOAJ |
| description | BackgroundCardiac autonomic neuropathy (CAN) is a common and severe chronic diabetic complication, whose association with thyroid function has rarely been reported.ObjectiveTo investigate the association between subclinical hypothyroidism and CAN in type 2 diabetes mellitus (T2DM) .MethodsWe performed a retrospective analysis of 564 outpatients and hospitalized patients with T2DM recruited from Beijing Friendship Hospital, Capital Medical University from October 2019 to October 2020. Baseline characteristics, physical and laboratory examination results were collected. Ewing test was performed to identify CAN. The association between subclinical hypothyroidism and CAN was assessed using the Pearson correlation coefficient and Spearman's rank coefficient of correlation. Factors associated with CAN in T2DM were identified using multivariate, stepwise logistic regression.ResultsOne hundred and twenty-nine subjects (22.9%) were found with CAN, and other 435 without. Subclinical hypothyroidism was detected in 84 cases (14.9%) , including 36 with CAN and 48 without. The prevalence of subclinical hypothyroidism in those with CAN〔28.0% (36/129) 〕 was higher than that of those without〔11.0% (48/435) 〕 (χ2=22.346, P<0.001) . For those with CAN, the ratio between maximum and minimum R-R intervals during the Valsalva maneuver demonstrated a negative correlation with the duration of T2DM, glycated hemoglobin, fasting plasma glucose, low-density lipoprotein cholesterol, triacylglycerol, high-sensitivity C-reactive protein, thyroid-stimulating hormone and urine albumin-to-creatinine ratio, while it demonstrated a positive correlation with the diastolic blood pressure (P<0.05) . The multivariate, stepwise logistic regression analysis revealed that subclinical hypothyroidism〔OR=1.717, 95%CI (1.246, 2.365) 〕was independently associated with increased risk of CAN in T2DM (P<0.05) .ConclusionIn type 2 diabetes patients, the level of TSH may be related to CAN, and subclinical hypothyroidism may be an independent associated factor of CAN. |
| first_indexed | 2024-04-24T11:59:03Z |
| format | Article |
| id | doaj.art-cab9a73795a74cf7a5e8e1ada5496d4c |
| institution | Directory Open Access Journal |
| issn | 1007-9572 |
| language | zho |
| last_indexed | 2024-04-24T11:59:03Z |
| publishDate | 2022-03-01 |
| publisher | Chinese General Practice Publishing House Co., Ltd |
| record_format | Article |
| series | Zhongguo quanke yixue |
| spelling | doaj.art-cab9a73795a74cf7a5e8e1ada5496d4c2024-04-09T02:52:28ZzhoChinese General Practice Publishing House Co., LtdZhongguo quanke yixue1007-95722022-03-0125091113111810.12114/j.issn.1007-9572.2021.02.128Association between Subclinical Hypothyroidism and Cardiac Autonomic Neuropathy in Type 2 Diabetes MellitusZHAO Lei, LI Ruqiang, YUAN Mingxia0 Department of Endocrinology，Beijing Friendship Hospital，Capital Medical University，Beijing 100050，China *Corresponding author：YUAN Mingxia，Professor，Chief physician；E-mail：mx.yuan@ccmu.edu.cn BackgroundCardiac autonomic neuropathy (CAN) is a common and severe chronic diabetic complication, whose association with thyroid function has rarely been reported.ObjectiveTo investigate the association between subclinical hypothyroidism and CAN in type 2 diabetes mellitus (T2DM) .MethodsWe performed a retrospective analysis of 564 outpatients and hospitalized patients with T2DM recruited from Beijing Friendship Hospital, Capital Medical University from October 2019 to October 2020. Baseline characteristics, physical and laboratory examination results were collected. Ewing test was performed to identify CAN. The association between subclinical hypothyroidism and CAN was assessed using the Pearson correlation coefficient and Spearman's rank coefficient of correlation. Factors associated with CAN in T2DM were identified using multivariate, stepwise logistic regression.ResultsOne hundred and twenty-nine subjects (22.9%) were found with CAN, and other 435 without. Subclinical hypothyroidism was detected in 84 cases (14.9%) , including 36 with CAN and 48 without. The prevalence of subclinical hypothyroidism in those with CAN〔28.0% (36/129) 〕 was higher than that of those without〔11.0% (48/435) 〕 (χ2=22.346, P<0.001) . For those with CAN, the ratio between maximum and minimum R-R intervals during the Valsalva maneuver demonstrated a negative correlation with the duration of T2DM, glycated hemoglobin, fasting plasma glucose, low-density lipoprotein cholesterol, triacylglycerol, high-sensitivity C-reactive protein, thyroid-stimulating hormone and urine albumin-to-creatinine ratio, while it demonstrated a positive correlation with the diastolic blood pressure (P<0.05) . The multivariate, stepwise logistic regression analysis revealed that subclinical hypothyroidism〔OR=1.717, 95%CI (1.246, 2.365) 〕was independently associated with increased risk of CAN in T2DM (P<0.05) .ConclusionIn type 2 diabetes patients, the level of TSH may be related to CAN, and subclinical hypothyroidism may be an independent associated factor of CAN.https://www.chinagp.net/fileup/1007-9572/PDF/yx2021123110.pdf|diabetes mellitus, type 2|diabetic neuropathies|diabetic cardiovascular autonomic neuropathy|subclinical hypothyroidism|root cause analysis |
| spellingShingle | ZHAO Lei, LI Ruqiang, YUAN Mingxia Association between Subclinical Hypothyroidism and Cardiac Autonomic Neuropathy in Type 2 Diabetes Mellitus Zhongguo quanke yixue |diabetes mellitus, type 2|diabetic neuropathies|diabetic cardiovascular autonomic neuropathy|subclinical hypothyroidism|root cause analysis |
| title | Association between Subclinical
Hypothyroidism and Cardiac Autonomic Neuropathy in Type 2 Diabetes Mellitus |
| title_full | Association between Subclinical
Hypothyroidism and Cardiac Autonomic Neuropathy in Type 2 Diabetes Mellitus |
| title_fullStr | Association between Subclinical
Hypothyroidism and Cardiac Autonomic Neuropathy in Type 2 Diabetes Mellitus |
| title_full_unstemmed | Association between Subclinical
Hypothyroidism and Cardiac Autonomic Neuropathy in Type 2 Diabetes Mellitus |
| title_short | Association between Subclinical
Hypothyroidism and Cardiac Autonomic Neuropathy in Type 2 Diabetes Mellitus |
| title_sort | association between subclinical hypothyroidism and cardiac autonomic neuropathy in type 2 diabetes mellitus |
| topic | |diabetes mellitus, type 2|diabetic neuropathies|diabetic cardiovascular autonomic neuropathy|subclinical hypothyroidism|root cause analysis |
| url | https://www.chinagp.net/fileup/1007-9572/PDF/yx2021123110.pdf |
| work_keys_str_mv | AT zhaoleiliruqiangyuanmingxia associationbetweensubclinicalhypothyroidismandcardiacautonomicneuropathyintype2diabetesmellitus |