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The association between thyroid dysfunction (TD) and diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM).
Int J Clin Pract 2019; :e13415IJ

Abstract

BACKGROUND

Epidemiological studies have identified an association between thyroid dysfunction (TD) and various kidney diseases. In this study, the prevalence of TD in type 2 diabetic mellitus (T2DM) patients with diabetic kidney disease (DKD) was evaluated to analyze the potential association between TD and DKD in T2DM patients.

METHODOLOGY

A total of 2,108 T2DM patients from Anhui Provincial Hospital were recruited in this study. Demographic and clinical characteristics were collected from 834 T2DM patients with DKD and 1,274 T2DM patients without DKD (non-DKD). All patients were stratified into a number of groups based on UACR (urine albumin-to-creatinine ratio) or eGFR (estimated glomerular filtration rate): e (1) A1: normoalbuminuria (<30), A2: microalbuminuria (30-300), and A3: macroalbuminuria (>300); (2) F1: normal filtration (60-139), F2: hyper filtration (≥ 140), and F3: low filtration (< 60).

RESULTS

Significant differences were observed between the non-DKD and DKD groups (P < 0.05) in age, sex ratio, duration, systolic blood pressure, total cholesterol, low density lipoprotein cholesterol, serum creatinine, blood urea nitrogen, free triiodothyronine (FT3), free thyroxine (FT4), and sensitive thyrotropin hormone (sTSH). The macro-albuminuira and low filtration groups had the lowest levels of FT3 and FT4 and the highest level of sTSH, compared with all other groups (P < 0.0167). The prevalence of subclinical hypothyroidism in the DKD group was significantly higher than that in the non-DKD group (χ2 =13.92, P < 0.01). Logistic regression analysis showed that hypothyroidism was associated with increased UACR or reduced eGFR in T2DM patients. Compared to controls, T2DM patients with hypothyroidism exhibited a higher UACR and urinary excretion of transferrin, as well as a lower excretion of urinary Tamm-Horsfall protein (THP) (P<0.0167).

CONCLUSION

Subclinical hypothyroidism is more prevalent in T2DM patients with DKD than in T2DM patients without DKD. Hypothyroidism is associated with albuminuria and decreased eGFR in T2DM patients. This article is protected by copyright. All rights reserved.

Authors+Show Affiliations

The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 23001, P. R. China.The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 23001, P. R. China.Department of Endocrinology, The Third Affiliated Hospital of AHMU, The First People's Hospital of Hefei City, Hefei, Anhui, 23001, P. R. China.Ethics Committee on Clinical Research, The First Affiliated Hospital of USTC, Hefei, Anhui, 23001, P. R. China.The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 23001, P. R. China.The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 23001, P. R. China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31508877

Citation

Zheng, Mao, et al. "The Association Between Thyroid Dysfunction (TD) and Diabetic Kidney Disease (DKD) in Type 2 Diabetes Mellitus (T2DM)." International Journal of Clinical Practice, 2019, pp. e13415.
Zheng M, Wang D, Chen L, et al. The association between thyroid dysfunction (TD) and diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM). Int J Clin Pract. 2019.
Zheng, M., Wang, D., Chen, L., Chen, M. N., Wang, W., & Ye, S. D. (2019). The association between thyroid dysfunction (TD) and diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM). International Journal of Clinical Practice, pp. e13415. doi:10.1111/ijcp.13415.
Zheng M, et al. The Association Between Thyroid Dysfunction (TD) and Diabetic Kidney Disease (DKD) in Type 2 Diabetes Mellitus (T2DM). Int J Clin Pract. 2019 Sep 11;e13415. PubMed PMID: 31508877.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The association between thyroid dysfunction (TD) and diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM). AU - Zheng,Mao, AU - Wang,Dong, AU - Chen,Li, AU - Chen,Mei-Nan, AU - Wang,Wei, AU - Ye,Shan-Dong, Y1 - 2019/09/11/ PY - 2019/9/12/entrez KW - diabetic kidney disease KW - hyperthyroidism KW - hypothyroidism KW - thyroid hormone KW - type 2 diabetic mellitus SP - e13415 EP - e13415 JF - International journal of clinical practice JO - Int. J. Clin. Pract. N2 - BACKGROUND: Epidemiological studies have identified an association between thyroid dysfunction (TD) and various kidney diseases. In this study, the prevalence of TD in type 2 diabetic mellitus (T2DM) patients with diabetic kidney disease (DKD) was evaluated to analyze the potential association between TD and DKD in T2DM patients. METHODOLOGY: A total of 2,108 T2DM patients from Anhui Provincial Hospital were recruited in this study. Demographic and clinical characteristics were collected from 834 T2DM patients with DKD and 1,274 T2DM patients without DKD (non-DKD). All patients were stratified into a number of groups based on UACR (urine albumin-to-creatinine ratio) or eGFR (estimated glomerular filtration rate): e (1) A1: normoalbuminuria (<30), A2: microalbuminuria (30-300), and A3: macroalbuminuria (>300); (2) F1: normal filtration (60-139), F2: hyper filtration (≥ 140), and F3: low filtration (< 60). RESULTS: Significant differences were observed between the non-DKD and DKD groups (P < 0.05) in age, sex ratio, duration, systolic blood pressure, total cholesterol, low density lipoprotein cholesterol, serum creatinine, blood urea nitrogen, free triiodothyronine (FT3), free thyroxine (FT4), and sensitive thyrotropin hormone (sTSH). The macro-albuminuira and low filtration groups had the lowest levels of FT3 and FT4 and the highest level of sTSH, compared with all other groups (P < 0.0167). The prevalence of subclinical hypothyroidism in the DKD group was significantly higher than that in the non-DKD group (χ2 =13.92, P < 0.01). Logistic regression analysis showed that hypothyroidism was associated with increased UACR or reduced eGFR in T2DM patients. Compared to controls, T2DM patients with hypothyroidism exhibited a higher UACR and urinary excretion of transferrin, as well as a lower excretion of urinary Tamm-Horsfall protein (THP) (P<0.0167). CONCLUSION: Subclinical hypothyroidism is more prevalent in T2DM patients with DKD than in T2DM patients without DKD. Hypothyroidism is associated with albuminuria and decreased eGFR in T2DM patients. This article is protected by copyright. All rights reserved. SN - 1742-1241 UR - https://www.unboundmedicine.com/medline/citation/31508877/The_association_between_thyroid_dysfunction_(TD)_and_diabetic_kidney_disease_(DKD)_in_type_2_diabetes_mellitus_(T2DM) L2 - https://doi.org/10.1111/ijcp.13415 DB - PRIME DP - Unbound Medicine ER -