Analysis of relationship between thyroid stimulating hormone and thyroid autoantibodies and cardiovascular disease risk stratification and cardiovascular events in patients with type 2 diabetes mellitus and hypertension but normal thyroid function

YUAN Lin; YUE Hong; PENG Wei; LI Ru

doi:10.3969/j.issn.1672-5301.2025.10.008

Abstract：Objective To investigate the relationship between thyroid-stimulating hormone(TSH),thyroglobulin antibody(TGAb)and thyroid peroxidase antibody(TPOAb)levels and cardiovascular disease(CVD)risk stratification and cardiovascular events in type 2 diabetes mellitus(T2DM)patients combined with hypertension with normal thyroid function.Methods A total of 204 patients with T2DM and hypertension with normal thyroid function admitted to Xi'an No.1 Hospital from June 2022 to October 2023 were selected and divided into the low-risk group(52 cases),the intermediate-risk group(34 cases)and the high-risk group(118 cases)according to The Chinese Guidelines for Cardiovascular Disease Risk Assessment and Management.The serum TSH,TGAb and TPOAb levels were compared among the three groups,and a Spearman correlation was performed to analyse the relationship between the serum TSH,TGAb and TPOAb levels and CVD risk stratification.They were categorised into the occurrence group(51 cases)and the non-occurrence group(153 cases)based on the occurrence of cardiovascular events.Comparisons of the general information and the levels of the serum TSH,TGAb and TPOAb between the occurrence and non-occurrence groups were conducted;multifactorial Logistic regression was used to analyse the risk factors for the occurrence of cardiovascular events;and the subject work characteristics(ROC)and their area under the curve(AUC)was used to analyse the predictive value of the serum TSH,TGAb and TPOAb levels for the occurrence of cardiovascular events in patients with T2DM and hypertension who had normal thyroid function.Results Compared with the low-risk group,the serum TSH,TGAb and TPOAb levels were higher in the intermediate-risk and high-risk groups;and they were higher in the high-risk group than in the intermediate-risk group(P<0.05).The results of Spearman's analysis suggested that the serum TSH,TGAb and TPOAb levels were positively associated with CVD risk stratification(P<0.05).The Glycosylated hemoglobin,type A1C(HbA1c),low-density lipoprotein cholesterol(LDL-C),TSH,TGAb and TPOAb were higher in the occurrence group than in the non-occurrence group(P<0.05).Analysed by multifactorial Logistic regression model showed that the high levels of HbA1c,LDL-C,TSH,TGAb and TPOAb were all the independent risk factors for cardiovascular events(P<0.05).The ROC results showed that the AUC of the serum TSH,TGAb and TPOAb levels alone and in combination to predict the occurrence of cardiovascular events in patients with T2DM and hypertension with normal thyroid function were 0.796(0.734-0.849),0.725(0.658-0.785),0.738(0.672-0.797),and 0.920(0.874-0.954);and the combined predictive efficacy of the three was higher(P<0.05).Conclusion The TSH,TGAb and TPOab levels are closely associated with CVD risk stratification and cardiovascular events in patients with T2DM and hypertension with normal thyroid function;and the combined serum TSH,TGAb and TPOab test has a higher predictive value for cardiovascular events.