2型糖尿病患者甲状腺激素敏感性指标与糖尿病周围神经病变的相关性

doi:10.3969/j.issn.1006-5725.2026.08.010

Abstract

Abstract:

Objective To investigate the associations of the thyroid feedback quantile-based index （TFQI）， the thyroid-stimulating hormone index （TSHI）， the thyrotropin resistance index （TT4RI）， and the free triiodothyronine/free thyroxine （FT₃/FT₄） ratio with diabetic peripheral neuropathy （DPN） in patients with type 2 diabetes mellitus （T2DM）. Methods A total of 100 patients with T2DM who were admitted to the hospital from May 2022 to May 2025 were enrolled in this study. Based on the presence or absence of DPN， these patients were divided into the DPN group （n = 43） and the non-DPN group （n = 57）. Clinical data were collected， and thyroid hormone sensitivity indices were calculated. The influencing factors for DPN in T2DM were identified through univariate and multivariate logistic regression analyses. The relationship between thyroid hormone sensitivity indices and DPN was explored via Spearman correlation analysis. The predictive efficacy of these indices for DPN in T2DM was evaluated by using the receiver operating characteristic （ROC） curve. Results In comparison with the non-DPN group， the DPN group exhibited significantly lower levels of FT₃， TFQI， TSHI， TT4RI， FT₃/FT₄， motor conduction velocity （MCV）， and sensory conduction velocity （SCV）. Moreover， patients in the DPN group were older （P < 0.05）. Multivariate logistic regression analysis indicated that TFQI （OR = 0.491， 95%CI： 0.260 - 0.926）， TSHI （OR = 0.594， 95%CI： 0.387 - 0.911）， TT4RI （OR = 0.418， 95%CI： 0.183 - 0.954）， and FT₃/FT₄ （OR = 0.540， 95%CI： 0.352 - 0.827） were independent factors influencing the occurrence of DPN in T2DM （P < 0.05）. Spearman correlation analysis demonstrated that TFQI， TSHI， TT4RI， and FT₃/FT₄ were significantly negatively correlated with DPN （r = -0.563， -0.501， -0.541， -0.292， P < 0.05）. ROC curve analysis disclosed that the area under the curve （AUC）， specificity， and sensitivity of the combination of thyroid hormone sensitivity indices for predicting DPN in patients with T2DM were 0.918， 90.70%， and 93.00%， respectively. The AUC and sensitivity were significantly higher than those of TFQI， TSHI， TT4RI， or FT₃/FT₄ when used alone （P < 0.05）. Conclusions In patients with T2DM， a decreased sensitivity to thyroid hormone indices is closely related to the occurrence of DPN， and these indices are independent influencing factors for DPN. The combined detection of these indices can improve the predictive efficacy for DPN.

Key words: type 2 diabetes mellitus, diabetic peripheral neuropathy, sensitivity to thyroid hormone, predictive value

CLC Number:

R578.2

Qingyin WANG,Shanshan LÜ,Honglin HU. Correlation between thyroid hormone sensitivity indices and diabetic peripheral neuropathy in patients with type 2 diabetes mellitus[J]. The Journal of Practical Medicine, 2026, 42(8): 1373-1378.

Figures/Tables 5

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Fig.1

References 26

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项目	DPN组（n = 43）	非DPN组（n = 57）	χ²/t值	P值
性别/[例（%）]			3.356	0.067
男	29（67.44）	27（47.37）
女	14（32.56）	30（52.63）
年龄/岁	54.86 ± 9.75	46.12 ± 10.14	4.337	< 0.001
BMI/（kg/m²）	23.47 ± 1.24	23.16 ± 1.37	1.166	0.246
T2DM病程/年	9.2503 ± 2.85	7.92 ± 2.77	1.959	0.0529
FPG/（mmol/L）	9.43 ± 3.21	8.65 ± 2.51	1.364	0.175
HbA_1c/%	8.21 ± 1.32	8.45 ± 1.07	1.004	0.318
C肽/（pmol/L）	728.81 ± 161.41	657.38 ± 195.63	1.946	0.055
TC/（mmol/L）	4.25 ± 1.10	4.72 ± 1.50	1.732	0.086
TG/（mmol/L）	1.56 ± 0.30	1.47 ± 0.36	1.328	0.187
HDL-C/（mmol/L）	1.16 ± 0.33	1.06 ± 0.28	1.636	0.105
LDL-C/（mmol/L）	2.58 ± 0.62	2.76 ± 0.56	1.520	0.132
Scr/（μmol/L）	51.86 ± 12.89	49.51 ± 11.91	0.942	0.348
HOMA-IR	2.92 ± 0.49	2.78 ± 0.53	1.350	0.180
TSH/（IU/mL）	2.03 ± 0.32	2.12 ± 0.29	1.469	0.145
FT₃/（pmol/L）	4.11 ± 0.56	4.79 ± 0.62	5.658	< 0.001
FT₄/（pmol/L）	15.22 ± 1.78	15.34 ± 1.61	0.353	0.725
TFQI	-0.17 ± 0.25	0.14 ± 0.18	7.934	< 0.001
TSHI	2.31 ± 0.36	2.86 ± 0.57	5.544	< 0.001
TT4RI	22.10 ± 2.35	25.14 ± 2.72	5.861	< 0.001
FT₃/FT₄	0.27 ± 0.04	0.31 ± 0.06	3.781	< 0.001
正中神经SCV/（m/s）	48.56 ± 5.16	53.25 ± 6.23	4.006	< 0.001
腓肠神经SCV/（m/s）	43.58 ± 5.02	55.21 ± 6.39	9.855	< 0.001
正中神经MCV/（m/s）	39.58 ± 4.68	52.47 ± 6.34	11.219	< 0.001
腓总神经MCV/（m/s）	41.28 ± 5.02	53.17 ± 6.21	10.272	< 0.001

指标	β	SE	Waldχ²	P值	OR	95%CI
年龄	0.563	0.316	3.174	0.076	1.756	0.945 ~ 3.262
FT₃	-0.652	0.421	2.398	0.122	0.521	0.228 ~ 1.189
TFQI	-0.712	0.324	4.829	0.029	0.491	0.260 ~ 0.926
TSHI	-0.521	0.218	5.712	0.017	0.594	0.387 ~ 0.911
TT4RI	-0.872	0.421	4.290	0.039	0.418	0.183 ~ 0.954
FT₃/FT₄	-0.617	0.218	8.010	0.005	0.540	0.352 ~ 0.827
正中神经SCV	-0.692	0.412	2.821	0.094	0.501	0.223 ~ 1.122
腓肠神经SCV	-0.717	0.395	3.295	0.070	0.488	0.225 ~ 1.059
正中神经MCV	-0.658	0.421	2.443	0.119	0.518	0.227 ~ 1.182
腓总神经MCV	-0.569	0.387	2.162	0.142	0.566	0.265 ~ 1.209

指标	AUC	标准误	P值	截断值	95%CI	特异度/%	灵敏度/%
TFQI	0.828	0.042	< 0.001	-0.05	0.746 ~ 0.911	68.80	84.20
TSHI	0.792	0.044	< 0.001	2.42	0.706 ~ 0.879	69.80	78.90
TT4RI	0.815	0.045	< 0.001	23.98	0.728 ~ 0.902	86.00	73.70
FT₃/FT₄	0.670	0.054	< 0.001	0.30	0.565 ~ 0.775	72.10	59.60
联合预测	0.918	0.032	< 0.001	-	0.855 ~ 0.982	90.70	93.00

Correlation between thyroid hormone sensitivity indices and diabetic peripheral neuropathy in patients with type 2 diabetes mellitus

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