兰州大学学报（医学版）2024，Vol.50Issue(4)：53-60,8.DOI:10.13885/j.issn.1000-2812.2024.04.009
甲状腺自身免疫与2型糖尿病心自主神经病变相关性的研究
Correlation between thyroid autoimmunity and cardiac auto-nomic neuropathy in patients with type 2 diabetes mellitus
摘要
Abstract
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.关键词
甲状腺自身免疫/心自主神经病变/心率变异性/2型糖尿病/糖尿病并发症Key words
thyroid autoimmunity/cardiac autonomic neuropathy/heart rate variability/diabetes mellitus type 2/diabetic complications分类
医药卫生引用本文复制引用
王珍,袁玥,邹婧怡,王梦珂,李淑云,吕海宏..甲状腺自身免疫与2型糖尿病心自主神经病变相关性的研究[J].兰州大学学报（医学版）,2024,50(4):53-60,8.基金项目
甘肃省卫生健康行业科研资助项目(GSWSKY2023-13) （GSWSKY2023-13）
甘肃省联合科研基金资助项目(23JRRA1499) （23JRRA1499）
兰州市城关区科技计划资助项目(2021JSCX0011) （2021JSCX0011）
