The correlation between vascular endothelial function and thyroid hormone sensitivity in newly diagnosed type 2 diabetes patients
Objective To explore the association between vascular endothelial function and the sensitivity to thyroid hormones in patients newly diagnosed type 2 diabetes mellitus(T2DM).Methods A cohort of 100 patients newly diagnosed with T2DM attending the endocrinology outpatient clinic of Beijing Chaoyang Hospital,Capital Medical University from June 2019 to November 2020 was enrolled.Key parameters measured encompassed fasting blood glucose(FBG),glycosylated hemoglobin A1c(HbA1c),free triiodothyronine(FT3),free thyroxine(FT4),thyroid-stimulating hormone(TSH),and lipid profiles among other metabolic indices.Indices of central thyroid hormone sensitivity,such as the thyroid feedback quantile index(TFQI),TSH index(TSHI),and the thyrotroph thyroxine resistance index(TT4RI),were computed based on FT4 and TSH levels,with higher values indicating diminished central thyroid hormone sensitivity.Conversely,the FT3/FT4 ratio was assessed as a marker of peripheral thyroid hormone sensitivity,with lower ratios suggesting reduced sensitivity.The homeostasis model assessment of insulin resistance(HOMA-IR)was caculated.The reactive hyperemia index(RHI)was measured across all participants to evaluate vascular endothelial function.Then,all subjects were divided into two groups based on RHI results:T2DM-ED group(RHI<1.67,43 cases)those with combined vascular endothelial dysfunctionand and T2DM-NED group(RHI≥1.67,57 cases)those without vascular endothelial dysfunction.Results The RHI level of the T2DM-ED group was 1.41±0.21,while the RHI level of the T2DM-NED group is 1.91±0.26.In comparison to the T2DM-NED group,individuals within the T2DM-ED group manifested markedly higher levels of low density lipoprotein-cholesterol(LDL-C),FBG and HbA1c(P<0.05).Furthermore,TSH,TFQI,TSHI and LnTT4RI were notably higher in the T2DM-ED group(P<0.05).Pearson correlation analysis revealed a negative correlation between RHI and LDL-C,FBG,LnHOMA-IR,HbA1c,TSH,TFQI,TSHI,and LnTT4RI,and a positive correlation with the FT3/FT4 ratio.Multivariate linear regression analysis identified HbA1c,LDL-C,TFQI,LnTT4RI,TSHI and TSH as factors associated with the reduction of RHI in patients newly diagnosed with T2DM.Conclusion The findings suggest that vascular endothelial dysfunction in newly diagnosed T2DM patients may be intricately linked to decreased sensitivity to thyroid hormones,underscoring the potential interplay between metabolic dysregulation and thyroid hormone pathways in the pathogenesis of T2DM-related vascular complications.
type 2 diabetes mellitusvascular endothelial functionthyroid hormone sensitivity
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