Relationship between thyroid hormone sensitivity indicators and mild cognitive impairment in patients with type 2 diabetes mellitus who have normal thyroid function
10.3760/cma.j.cn341190-20240520-00596
- VernacularTitle:甲状腺激素敏感性指标与甲状腺功能正常的T2DM患者轻微认知功能障碍的关系
- Author:
Longlong WANG
1
;
Yijuan SUN
1
;
Yanni LI
1
Author Information
1. 商洛市中心医院医学检验科，商洛 726000
- Publication Type:Journal Article
- Keywords:
Diabetes mellitus, type 2;
Thyroid function tests;
Thyroxine;
Triiodothyronine;
Hemoglobin A, glycosylated;
Cognitive dysfunction;
Forecasting
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(1):14-20
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between thyroid hormone sensitivity indicators and the risk of mild cognitive impairment (MCI) in patients with type 2 diabetes mellitus (T2DM) who have normal thyroid function.Methods:A retrospective study design was used to gather data from 100 patients with T2DM who had normal thyroid function and were treated at Shangluo Central Hospital between June 2022 and January 2024. The Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were used for evaluation. Patients with an MMSE score of ≤ 26 or a MoCA score of ≤ 26 were included in the MCI group ( n = 22), whereas those with an MMSE score of > 26 and a MoCA score of > 26 were included in the non-MCI group ( n = 78). Multivariate logistic regression analysis was performed to identify factors influencing MCI in patients with T2DM. Additionally, receiver operating characteristic curve analysis was conducted to assess the predictive value of thyroid hormone sensitivity indicators for MCI in this patient population. Results:In the MCI group, 68.18% of patients had an education level of high school or below. The level of glycosylated hemoglobin in this group was (8.45 ± 1.95)%, insulin resistance index was (3.34 ± 0.25), the level of triglycerides was (2.59 ± 0.19) mmol/L, the level of uric acid was (354.76 ± 46.16) μmol/L, thyroid-stimulating hormone index was (3.09 ± 0.26), and thyroid feedback quantile-based index was [0.2 (0.0, 0.5)]. All of these values were significantly higher than those in the non-MCI group: [43.59%, (7.63 ± 1.61)%, (3.05 ± 0.17), (2.09 ± 0.15) mmol/L, (311.74 ± 67.15) μmol/L, (2.87 ± 0.13), 0.2 (-0.1, 0.4), χ2 = 4.15, t = 2.01, 6.32, 12.99, 3.47, 5.47, Z = -2.54, all P < 0.05]. In the MCI group, the level of free triiodothyronine was (4.32 ± 0.21) pmol/L, and thyrotroph T4 resistance index (TT4RI) was (34.54 ± 4.30), both of which were significantly lower than those in the non-MCI group [(4.61 ± 0.36) pmol/L, (37.15 ± 5.55), t = 2.58, 2.04, both P < 0.05]. There were no significant differences in gender, age, body mass index, alcohol consumption, smoking, history of cerebral infarction, hypertension, duration of diabetes, use of only metformin, fasting blood glucose, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol, alanine aminotransferase, aspartate aminotransferase, free thyroxine, and thyroid-stimulating hormone between the two groups (all P > 0.05). Logistic regression analysis indicated that education level, triglyceride, uric acid, free triiodothyronine, thyroid-stimulating hormone index, and TT4RI were risk factors for MCI (all P < 0.05). The predictive value of the combined thyroid hormone sensitivity indicators for MCI in patients with T2DM was high, with an area under the receiver operating characteristic curve of 0.778 [95% CI(0.676, 0.880), P < 0.001], a sensitivity of 0.538, a specificity of 0.909, and a maximum Youden index of 0.447. Conclusions:In patients with T2DM who have normal thyroid function, the thyroid hormone sensitivity indicators (TT4RI and thyroid feedback quantile-based index) exhibited a negative correlation with MCI, whereas TSHI demonstrated a positive correlation with MCI. The combined use of these thyroid hormone sensitivity indicators is valuable for predicting MCI and offers significant guidance for the early intervention of cognitive impairment in patients with T2DM.
