Musiienko V. Prediction factors for the risk of thyroid pathology in type 2 diabetic patients and macrovascular complications in comorbid conditions

The thesis deals with a new scientifically based theoretical generalization and provides a solution to a pressing matter, which is outlining main pathogenic features typical of comorbid type 2 diabetes in combination with diffuse non-toxic goiter and hypothyroidism, as well as increasing the efficiency of thyroid pathology diagnostics and prophylaxis in patients with type 2 diabetes, and prognosis of macrovascular complications under the condition of their comorbid presence. Due to the conducted scientific research mathematical models of thyroid disease development prognosis in patients with type 2 diabetes were designed; these models give an opportunity to single out cohort of patients with high risk of development of hypothyroidism and diffuse non-toxic goiter on the basis of routine laboratory tests results. This research adds to the scientific data on lipid profile disorders in patients with T2DM and its comorbities. Researching lipid profile it was found out that odds ratio was significantly higher than target levels in regard to the levels of TC, non-HDL cholesterol, and lower than target levels in regard to the level of HDL cholesterol in patients with comorbid T2DM and hypothyroidism, as well as T2DM and diffuse non-toxic goiter. Moreover, a significantly bigger number of patients with T2DM and hypothyroidism had higher level of LDL cholesterol than target level. Within the group T2DM + HT + DNG it was found out that concentration of TC was higher than target level in all patients. At the same time, in patients with comorbid T2DM, HT and DNG odds ratio was significantly higher than target levels in regard to the levels of TG and TC; and significantly lower than target levels in regard to the levels of HDL cholesterol. The connection among comorbid type 2 diabetes, hypothyroidism, diffuse non-toxic goiter and macroangiopathy with dyslipidemia was established. With the help of ROC-analysis optimal lipid profile cut-offs points were calculated; they indicate relative risk of macrovascular complications in patients with T2DM and hypothyroidism: TC > 5.11 mmol/L, TG ≥ 2.03 mmol/L, LDL cholesterol ≥ 2.97 mmol/L and non-HDL cholesterol ≥ 4.29 mmol/L; in patients with type 2 diabetes with comorbid diffuse non-toxic goiter: TC ≥ 4.97 mmol/L, TG ≥ 2.54 mmol/L, LDL cholesterol ≥ 3.21 mmol/L and non-HDL cholesterol ≥ 4.20 mmol/L; in patients with comorbid type 2 diabetes, hypothyroidism and diffuse non-toxic goiter TC ≥ 4.89 mmol/L, TG ≥ 1.56 mmol/L, LDL cholesterol ≥ 2.93 mmol/L, non-HDL cholesterol ≥ 4.04 mmol/L and RC ≥ 1.14 mmol/L.