Association between thyroid hormone sensitivity and diabetic retinopathy in patients with type 2 diabetes mellitus
10.3969/j.issn.1006-6187.2025.10.001
- VernacularTitle:2型糖尿病患者甲状腺激素敏感性与糖尿病视网膜病变相关性的研究
- Author:
Xiaomeng YU
1
;
Ning WANG
Author Information
1. 274000 菏泽市牡丹人民医院内分泌代谢科
- Publication Type:Journal Article
- Keywords:
Diabetes mellitus,type 2;
Diabetic retinopathy;
Thyroid function;
Thyroid hormone sensitivity
- From:
Chinese Journal of Diabetes
2025;33(10):721-726
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the correlation between thyroid hormone(TH)sensitivity and diabetic retinopathy(DR)in type 2 diabetes mellitus(T2DM)patients with normal thyroid function.Methods A total of 776 patients with T2DM and normal thyroid function who were hospitalized in the Department of Endocrinology and Metabolism in Heze Mudan People's Hospital between July 2023 and January 2025 were enrolled in this study.They were divided into the simple T2DM group(n=456)and the DR group(n=320)based on the presence or absence of DR.The general data,biochemical indicators,thyroid feedback quartile index(TFQI),parameterized TFQI(PTFQI),thyroid stimulating hormone index(TSHI),thyroid resistance index(TT4RI),free triiodothyronine/free thyroxine(FT3/FT4),etc.were compared between the two groups.Logistic regression analysis was used to explore the influencing factors of DR.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of thyroid function-related parameters for DR.Results The DR group had higher age,the proportion of hypertension,the proportion of coronary heart disease,DM duration,the proportion of smoking,hemoglobin A1c(HbA1c),triglycerides,thyroid stimulating hormone(TSH),TFQI,PTFQI,TSHI,and TT4RI(P<0.05),while the proportion of male,fasting C-peptide,and FT4 were lower compared with the T2DM group(P<0.05).Logistic regression analysis revealed that age,DM duration,the proportion of smoking,TFQI,PTFQI,TT4RI,TSHI,and HbA1c were the influencing factors for the occurrence of DR in patients with T2DM.After adjusting for confounding factors,the risk of DR increased for each indicator in the Q4 groups compared with the Q1 quartile groups of TFQI,PTFQI,TT4RI,and TSHI respectively(OR 1.954,1.080,1.853,2.028,95%CI 1.039～3.676,1.035～1.127,1.003～3.426,1.090～3.775).The ROC curve analysis showed that the areas under the curve in predicting the occurrence of DR in patients with T2DM were 0.648,0.609,0.590,and 0.580 for TFQI,PTFQI,TT4RI,and TSHI respectively,and the sensitivities were 0.385,0.647,0.465,and 0.601 respectively,while the specificities were 0.615,0.578,0.258,and 0.541 respectively.Conclusions Central resistance to TH is associated with an elevated risk of DR in euthyroid patients with T2DM.
