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Objective To investigate the incidence of low triiodothyronine (T3) syndrome in type 2 diabetes mellitus (T2DM) and its correlation with the development of diabetic nephropathy (DN). Methods A total of 185 patients with T2DM hospitalized in Central Hospital of Bengbu from January 2020 to February 2022 were retrospectively selected and divided into three groups according to urinary albumin to creatinine ratio (ACR) : normoalbuminuria group (group A ,n=84, ACR＜30 mg/g), microalbuminuria group (group B, n=54, 30 mg/g≤ACR＜300 mg/g) and macroalbuminuria group (group C,n=47, ACR≥300 mg/g). Venous blood lipid, glycosylated hemoglobin (HbA1c), and liver, kidney and thyroid function levels were measured to analyze the correlation between thyroid function and ACR. The estimated glomerular rate filtration (eGFR) was calculated by serum creatinine according to the CKD-EPI formula. The diagnosis of low T3 syndrome was confirmed by combining the inverse T3(rT3) level, Results With the increase of ACR level (group A → group B → group C), plasma T3 and free T3 (FT3) levels were gradually decreased (F=9.019, 18.702, P＜0.01), and the incidence of low T3 syndrome was gradually increased in group A (0), group B (3.70%) and group C (14.89%) (χ2=14.666, P＜0.01). There were statistically significant differences in age, smoking history, diabetes course, systolic blood pressure, albumin, blood urea nitrogen, eGFR, FT3 and T3 among the three groups (P＜0.05). Multiple linear regression analysis showed that FT3 was negatively correlated with ACR (β=-0.330, P＜0.05), systolic blood pressure was positively correlated with ACR (β=0.203, P＜0.05). Conclusion The occurrence of low T3 syndrome in T2DM patients is related to ACR level. Early detection of thyroid hormone level is helpful for the early diagnosis and disease evaluation of T2DM patients with DN.

Objective To investigate the association between glycated hemoglobin A1c (HbA1c) and subclinical left ventricular (LV) systolic function in patients with type 2 diabetes mellitus (T2DM). Methods T2DM patients who consecutively admitted to the Department of Endocrinology, First Affiliated Hospital of Air Force Medical University, Shaanxi Province from June to December 2021 were selected. The age, heart rate, systolic blood pressure, fasting plasma glucose (FPG), HbA1c, triglyceride (TG) and urinary albumin to creatinine ratio (UACR), LV global longitudinal strain (GLS) were collected. According to the GLS results, patients were divided into three groups: T1 (GLS≤16.6%), T2 (16.6%19.4%). One-way analysis of variance, Fisher exact test or chi-square test, and Kruskal-Wallis H test were used to compare the differences in clinical characteristics and metabolic indexes among groups. Pearson correlation analysis was used to evaluate the correlation between HbA1c and GLS, and multiple linear regression analysis was used to analyze the influencing factors of LV subclinical myocardial systolic dysfunction in patients with T2DM. Results A total of 152 patients were included. There were 51 cases in T1 group, 51 cases in T2 group, and 50 cases in T3 group. HbA1c level decreased with increasing GLS group [(10.01± 2.39)% vs. (8.69±1.77)% vs. (7.78±1.38)%, P<0.001]. Pearson correlation analysis showed that HbA1c was negatively correlated with GLS (r=-0.48, P<0.001). The results of univariate linear regression analysis showed that HbA1c, age, heart rate, systolic blood pressure, FPG, TG and UACR were significantly correlated with GLS (all P<0.05). Multivariate analysis showed that HbA1c was independently associated with GLS (β =-0.613, P<0.001). In addition, the results showed that logUACR was an independent and major risk factor for reduced GLS (β =-1.010, P=0.024). Conclusions HbA1c was negatively associated with the progression of LV subclinical systolic function in patients with T2DM. High UACR level was the main influencing factor of LV longitudinal dysfunction. [ABSTRACT FROM AUTHOR]