Subklinički hopotireoidizam doprinosi makrovaskularnim komplikacijama u bolesnika s dijabetes melitusom tip 2

This study aimed to evaluate changes of the lipid panel data in patients with comorbid type 2 diabetes mellitus (T2DM) and subclinical hypothyroidism (SCH) and to identify the probable prognostic values of the lipid profile for macrovascular complication (MVC) development. The study included 370 patients presented with only T2DM and 30 patients suffering from both T2DM and SCH. Receiver operating characteristic (ROC) analysis was used to identify prognostically significant values of the lipid profile with the optimal ratio of sensitivity and specificity for MVC development. All lipid profile values in the patients with T2DM combined with SCH were significantly higher compared to those with only T2DM. At the same time, SCH + T2DM increased the risk of exceeding target levels of triglycerides by 2.9 times and HDL-C by 4.1 times. Analysis of lipid profile values according to macrovascular involvement showed that total cholesterol, LDL-C and non-HDL-C in patients with T2DM and SCH were significantly higher compared to those with only T2DM. The levels of triglycerides >1.65 mmol/L, non-HDL-C >3.74 mmol/L and remnant cholesterol >0.74 mmol/L determined by the ROC analysis can be used for stratification of patients with T2DM combined with SCH into the category of increased risk of MVC development.Cilj istraživanja bio je procijeniti promjene u lipidnom profilu kod bolesnika s dijabetes melitusom tip 2 (T2DM) i subkliničkim hipotireoidizmom (SCH) te utvrditi vjerojatne prognostičke vrijednosti lipidnog profila za razvoj makrovaskularnih komplikacija (MVK). U studiju je bilo uključeno 370 bolesnika koji su imali samo T2DM i 30 bolesnika koji su imali i T2DM i SCH. Prognostički značajne vrijednosti lipidnog profila s optimalnim omjerom osjetljivosti i specifičnosti za razvoj MVK utvrđene su analizom krivulje ROC. Sve vrijednosti lipidnog profila bile su značajno više u bolesnika s T2DM u kombinaciji sa SCH u usporedbi s bolesnicima koji su imali samo T2DM. Istodobna prisutnost SCH i T2DM povećala je rizik od prekoračenja ciljnih razina triglicerida 2,9 puta i HDL kolesterola 4,1 puta. Analiza vrijednosti lipidnog profila u odnosu na zahvaćenost makrovaskularnih struktura pokazala je da su ukupni kolesterol, LDL kolesterol i ne-HDL kolesterol značajno viši u bolesnika s T2DM i SCH u usporedbi s onima koji imaju samo T2DM. Razine triglicerida >1,65 mmol/L, ne-HDL kolesterola >3,74 mmol/L i ostatnog kolesterola >0,74 mmol/L utvrđene analizom ROC mogu poslužiti za prepoznavanje bolesnika s T2DM i SCH kao skupine s povišenim rizikom za razvoj MVK

Susquenita Sch Dist v. S.

USDC for the Middle District of Pennsylvani

Cent Dauphin Sch v. S.

United States District Court for the Middle District of Pennsylvani

S. v. Sch Dist Pittsburgh

USDC for the Western District of Pennsylvani