Correlation between thyroid autoimmunity and cardiac auto-nomic neuropathy in patients with type 2 diabetes mellitus
Objective To analyze the correlation between thyroid autoimmunity and cardiac autonomic neu-ropathy(CAN)in patients with type 2 diabetes mellitus(T2DM),and to provide new ideas for the preven-tion and treatment of CAN in patients with T2DM.Methods A total of 276 T2DM patients were selected and divided into two groups,that is,CAN(+)group and CAN(-)group,according to cardiovascular autonomic reflex tests.A 24-hour holter electrocardiogram was performed,heart rate variability parameters collected,Spearman correlation was used to analyze the correlation between thyroid autoimmunity and CAN,and bina-ry Logistic regression was used to analyze the influencing factors of CAN in T2DM patients.Results Baseline data showed that thyroid peroxidase antibody(TPO-Ab),thyroglobulin antibody(TgAb)and homeostatic model assessment-insulin resistance of patients in the CAN(+)group were significantly higher than those in CAN(-)group(P<0.05).TPO-Ab was significantly negatively correlated with 24-hour standard deviation of normal-to-normal R-R intervals(r=-0.148,P=0.014),average standard deviation of normal-to-normal R-R intervals every 5 minutes for 24 hours(r=-0.152,P=0.011),root mean square of successive differences between normal heartbeats over 24 hours(rMSSD,r=-0.317,P<0.001),percentage of differences between adjacent normal R-R intervals over 24 hours that were greater than 50 ms(pNN50,r=-0.367,P<0.001)and high frequency(r=-0.353,P<0.001),and significantly positively correlated with the low frequency/high frequency(r=0.671,P<0.001);TgAb was negatively correlated with rMSSD(r=-0.257,P<0.001),pNN50(r=-0.308,P<0.001)and high frequency(r=-0.273,P<0.001),and positively correlated with low frequency/high frequency(r=0.551,P<0.001).Binary Logistic regression analysis suggested that TPO-Ab was an inde-pendent influencing factor for CAN in T2DM patients.Receiver operating characteristic curve analysis showed that the optimal threshold of TPO-Ab for predicting CAN was 7.35 U/mL.Conclusion Thyroid autoantibody TPO-Ab may have a certain predictive value for the occurrence and development of CAN in patients with T2DM and,for T2DM with positive TPO-Ab,it is necessary to regularly monitor cardiac auto-nomic nervous function to prevent the occurrence of CAN.
thyroid autoimmunitycardiac autonomic neuropathyheart rate variabilitydiabetes mellitus type 2diabetic complications
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