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It has been recognized that Type 2 diabetes mellitus and subclinical hypothyroidism had involved in the occurrence and development of coronary heart disease. At the same time, hypothyroidism is common in Type 2 diabetic populations, especially the subclinical hypothyroidism. More studies have focused on T2DM with SCH could aggravate metabolic disorder of lipid in recent years. However, there is less reports about the cardiovascular risk caused by whether T2DM combine SCH can pass the lipid metabolism or not. Therefore,the focus of the article is to study the correlation between sublinical hypothyroidism and cardivascular disease in T2DM.Objective:To study the correlation between subclinical hypothyroidism and cardiovascular disease in Type 2 diabetic patients, and to explore the pathogenesis whether SCH complicated with T2DM patients aggravate the disorder of lipid metabolism and increase the risk factor for CHD or not.Methods:90 cases with coronary heart disease in Type 2 diabetic patients ,who have acceptted hospitalization treatment in our hospital from January 2010 to December 2010, were admitted and divided into two groups according to thyroid function:(1)Euthyroid Group: the levels of TSH and FT4、FT3 are all in normal range A total of 60 cases. Of which 25 cases are male and 35 females, male: female=5:7, the average years(64.33+8.90)years,diabetic duration(7.80±3.57)years, BMI( 24.33±1.72 )kg/m2。(2)SCH Group: the level of TSH >5.6mu/L,and meantime the levels of FT4、FT3 are normal.A total of 30 cases. Of which 5 cases are male and 25 females, male: female=1:5, the average years(65.50±9.45)years, diabetic duration (7.87±3.55)years, BMI( 24.01±2.38)kg/m2。Fasting venous blood extraction, FT3、FT4、TSH、FPG、TC、TG、HDL-C、LDL-C were tested and clinical characteristics were also examined. Pairs of experimental data obtained were analyzed statistically.Patients had following problems should be excluded:①Patients who had hypothalamus and pituitary diseases、cancer、severe liver and kidney dysfunction、heart failure、respiratory failure.②Patients who had Hypothyroidism with L-T4 replacement therapy underdosed.③Patients who had primary adrenal insufficiency Without treatment.④Patients who took lipid -lowering drugs nearly three months.⑤Pregnant women.Results:(1)The general Information such as age structure(t =0.575, P =0.567,P>0.05)、diabetic duration(t=0.084, P=0.933,P>0.05)and BMI(t =0.714, P =0.477, P>0.05)、smoking status(χ2=0.089, P =0.765,P>0.05)of the SCH group and the Euthyroid Group were no significant difference;But the difference of the gender structer in two groups was statistically significan(tχ2 =0.575, P =0.018,P<0.05)(.2)FT3、FT4、TSH and biochemical index were compared between the SCH group and the Euthyroid Group: FT3(t =1.509, P=0.135, P>0.05)、SBP(t =0.577, P =0.565,P>0.05)、DBP(t =0.692, P =0.491,P>0.05)、HDL-C( t =1.486, P =0.141, P>0.05) of the SCH group and the Euthyroid Group were no significant difference;But FT4(t =3.494, P =0.001,P<0.05,)、TSH(t =8.506, P =0.000,P<0.05)、TG(t =2.219, P =0.029,P<0.05)、TC(t =2.220, P =0.029,P<0.05)、LDL-C(t =2.075, P =0.041,P<0.05)and FPG(t =2.036, P =0.045,P<0.05)of the SCH group and the Euthyroid Group were statistically significant,which indicates that FT4、FPG levels of SCH Group were lower than Euthyroid Group ,while TSH、TC、TG、LDL-C levels of SCH Group were higher than Euthyroid Group.Conclusions:Subclinical hypothyroidism complicated with cardiovascular disease in Type 2 diabetic patients occurs mostly in females, SCH complicated with T2DM may aggravate the disorder of lipid metabolism, which increase the risk factor for CHD, and it may have no relationship between sublinical hypothyroidism complicated with cardiovascular disease in Type 2 diabetic patients and the changes in blood glucose level.
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