脂代谢 IGF-1及HbA1c水平与T2DM合并甲状腺结节性质的关系研究

doi:10.3969/j.issn.1006-6233.2023.06.019

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Abstract Objective: To investigate the relationship between lipid metabolism, serum levels of insulin-like growth factor-1 (IGF-1) and glycosylated hemoglobin (HbA1c) and the nature of thyroid nodules in patients with type 2 diabetes mellitus (T2DM). Methods: 137 patients with T2DM combined with thyroid nodules treated in our hospital from May 2020 to May 2022 were selected as the observation group, while 140 patients with T2DM alone were selected as the control group, the differences in lipid metabolism, IGF-1, HbA1c, etc. between the two groups were compared, and the differences in lipid metabolism, IGF-1, HbA1c, etc. between patients with benign and malignant nodules in the observation group were analyzed. Results: The course of T2DM, fasting blood glucose (FBG), fasting insulin (FINS), glycosylated hemoglobin (HbA1c), insulin resistance index (HOMA-IR), triglyceride (TG), TG/HDL-C and IGF-1 in the observation group were (10.50 ± 2.43) years, (11.40 ± 2.11) mmol/L, (24.49 ± 3.32) mIU/L, (9.60 ± 1.83)%, (12.45 ± 2.11), (4.14 ± 1.02) mmol/L, (3.05 ± 0.92) and (220.10 ± 70.20) ng/ml, respectively, which was significantly higher than that in the control group (P<0.05). There was no significant difference between the observation group and the control group in blood glucose at 2h after meal (2hPG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), TC/HDL-C and LDL-C/HDL-C (P>0.05). HbA1c, TG, TG/HDL-C and IGF-1 in patients with malignant nodules of observation group were (10.21 ± 1.60)%, (4.76 ± 1.56) mmol/L, (3.50 ± 0.90) and (243.32 ± 51.26) ng/ml, respectively, higher than those in patients with benign nodules (P<0.05). TG, TG/HDL-C were positively correlated with HbA1c (P<0.05). IGF-1 had no significant correlation with TG, TG/HDL-C and HbA1c (P>0.05). The area under ROC curve predicted by TG, TG/HDL-C, IGF-1, HbA1c to predict malignant nodules were 0.621, 0.705, 0.727, 0.687 respectively (P<0.05). Conclusion: In T2DM patients with thyroid nodules, lipid metabolism is significantly abnormal, IGF-1 and HbAIc are significantly increased, and TG, TG/HDL-C, IGF-1 and HbA1c has certain application value in predicting benign and malignant thyroid nodules.

Key words： Type 2 diabetes Thyroid nodules Lipid metabolism Insulin like growth factor-1 Glycosylated hemoglobin Nodular nature

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2023.06.019 OR http://www.hbyxzzs.cn/EN/Y2023/V29/I6/977

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