Association between sensitivity to thyroid hormones and non-high-density lipoprotein cholesterol levels in patients with type 2 diabetes mellitus.

IF 4.2 3区医学 Q1 ENDOCRINOLOGY & METABOLISM World Journal of Diabetes Pub Date : 2024-10-15 DOI:10.4239/wjd.v15.i10.2081

Xiao-Ye Duan, Jun-Ling Fu, Li-Na Sun, Zhi-Jing Mu, Shuang-Ling Xiu

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Abstract

Background: Dyslipidemia and type 2 diabetes mellitus (T2DM) are chronic conditions with substantial public health implications. Effective management of lipid metabolism in patients with T2DM is critical. However, there has been insufficient attention given to the relationship between thyroid hormone sensitivity and dyslipidemia in the T2DM population, particularly concerning non-high-density lipoprotein cholesterol (non-HDL-C).

Aim: To clarify the association between thyroid hormone sensitivity and dyslipidemia in patients with T2DM.

Methods: In this cross-sectional study, thyroid hormone sensitivity indices, the thyroid feedback quantile-based index (TFQI), the thyroid-stimulating hormone index (TSHI), the thyrotrophic T4 resistance index (TT4RI), and the free triiodothyronine (FT3)/free thyroxine (FT4) ratio were calculated. Logistic regression analysis was performed to determine the associations between those composite indices and non-HDL-C levels. Random forest variable importance and Shapley Additive Explanations (SHAP) summary plots were used to identify the strength and direction of the association between hyper-non-HDL-C and its major predictor.

Results: Among the 994 participants, 389 (39.13%) had high non-HDL-C levels. Logistic regression analysis revealed that the risk of hyper-non-HDL-C was positively correlated with the TFQI (OR: 1.584; 95%CI: 1.088-2.304; P = 0.016), TSHI (OR: 1.238; 95%CI: 1.034-1.482; P = 0.02), and TT4RI (OR: 1.075; 95%CI: 1.006-1.149; P = 0.032) but was not significantly correlated with the FT3/FT4 ratio. The relationships between composite indices of the thyroid system and non-HDL-C levels differed according to sex. An increased risk of hyper-non-HDL-C was associated with elevated TSHI levels in men (OR: 1.331; 95%CI: 1.003-1.766; P = 0.048) but elevated TFQI levels in women (OR: 2.337; 95%CI: 1.4-3.901; P = 0.001). Among the analyzed variables, the average SHAP values were highest for TSHI, followed by TT4RI.

Conclusion: Impaired sensitivity to thyroid hormones was associated with high non-HDL-C levels in patients with T2DM.

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2 型糖尿病患者对甲状腺激素的敏感性与非高密度脂蛋白胆固醇水平之间的关系。

背景：血脂异常和 2 型糖尿病（T2DM）是对公众健康有重大影响的慢性疾病。有效管理 T2DM 患者的血脂代谢至关重要。目的：阐明甲状腺激素敏感性与 T2DM 患者血脂异常之间的关系：在这项横断面研究中，计算了甲状腺激素敏感性指数、甲状腺反馈量子化指数（TFQI）、促甲状腺激素指数（TSHI）、甲状腺T4抵抗指数（TT4RI）和游离三碘甲状腺原氨酸（FT3）/游离甲状腺素（FT4）比值。为确定这些综合指数与非高密度脂蛋白胆固醇水平之间的关系，进行了逻辑回归分析。随机森林变量重要性和夏普利加性解释（SHAP）汇总图用于确定高非-HDL-C与其主要预测因子之间的关联强度和方向：在 994 名参与者中，有 389 人（39.13%）非高密度脂蛋白胆固醇水平偏高。逻辑回归分析显示，高非-HDL-C风险与TFQI（OR：1.584；95%CI：1.088-2.304；P = 0.016）、TSHI（OR：1.238；95%CI：1.034-1.482；P = 0.02）和TT4RI（OR：1.075；95%CI：1.006-1.149；P = 0.032）呈正相关，但与FT3/FT4比值无显著相关。甲状腺系统综合指数与非高密度脂蛋白胆固醇水平之间的关系因性别而异。男性非高密度脂蛋白胆固醇过高的风险与 TSHI 水平升高有关（OR：1.331；95%CI：1.003-1.766；P = 0.048），但女性 TFQI 水平升高（OR：2.337；95%CI：1.4-3.901；P = 0.001）。在分析的变量中，TSHI的平均SHAP值最高，其次是TT4RI：结论：甲状腺激素敏感性受损与T2DM患者非高密度脂蛋白胆固醇水平过高有关。

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来源期刊

World Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

自引率

2.40%

发文量

909

期刊介绍： The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.