Subclinical hypothyroidism and diabetic nephropathy in Iranian patients with type 2 diabetes

Journal of Endocrinological Investigation - Tập 40 - Trang 289-295 - 2016
N. Mansournia1, S. Riyahi1, S. Tofangchiha2, M. A. Mansournia3, M. Riahi4, Z. Heidari5, E. Hazrati6
1Department of Endocrinology and Metabolism, AJA University of Medical Sciences, Tehran, Iran
2Department of Internal Medicine, AJA University of Medical Sciences, Tehran, Iran
3Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
4School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
5Department of Endocrinology and Metabolism, Zahedan University of Medical Sciences, Zahedan, Iran
6Department of Anesthesiology, AJA University of Medical Sciences, Tehran, Iran

Tóm tắt

Association of subclinical hypothyroidism with type 2 diabetes and its complications has been previously documented. These reports were, however, inconclusive and mainly gathered from Chinese and East Asian populations. In this study, we aimed to determine the prevalence of subclinical hypothyroidism and its relationship with diabetic nephropathy in Iranian individuals with type 2 diabetes, drawn from a white Middle Eastern population with an increasing prevalence of diabetes. In this cross-sectional study, 255 Iranian participants with type 2 diabetes and without history of thyroid disorders were included. Patients with TSH > 4.2 mIU/L and normal T4 were classified as having subclinical hypothyroidism. Diabetic nephropathy was diagnosed based on abnormal 24-h urinary albumin or protein measurements (24-h urinary albumin ≥30 mg/day or 24-h urinary protein ≥150 mg/day). Multivariate logistic regression was employed to obtain the OR for the relationship between subclinical hypothyroidism and diabetic nephropathy. We found that subclinical hypothyroidism and diabetic nephropathy were as prevalent as 18.1 and 41.2 %, respectively, among the participants. We also found that subclinical hypothyroidism was independently associated with higher rates of diabetic nephropathy, after multivariable adjustment (OR [95 % CI] 3.23 [1.42–7.37], p = 0.005). We found that the prevalence of subclinical hypothyroidism in Iranian diabetic population was among the highest rates reported to date. Our data supported the independent association of subclinical hypothyroidism with diabetic nephropathy, calling for further investigations to evaluate their longitudinal associations.

Tài liệu tham khảo

Standards of Medical Care in Diabetes–2012 (2012) Diabetes Care 35(Suppl 1):S11–S63. doi:10.2337/dc12-s011

Molitch ME, Defronzo RA, Franz MJ, Keane WF, Mogensen CE, Parving H, Steffes M (2004) Nephropathy in diabetes. Diabetes Care 27:S79–S83

Derakhshan A, Sardarinia M, Khalili D, Momenan AA, Azizi F, Hadaegh F (2014) Sex specific incidence rates of type 2 diabetes and its risk factors over 9 years of follow-up: Tehran Lipid and Glucose Study. PLoS ONE 9(7):e102563

Akbari A, White CA, Shahbazi N, Booth RA, Hiremath S, Knoll GA (2012) Spot urine protein measurements: are these accurate in kidney transplant recipients? Transplantation 94(4):389–395

Zhang D, Zhang L, Zhang Y, Zeng Y, Li L (2014) Association of subclinical hypothyroidism with diabetic chronic complications in type 2 diabetic patients (Article in Chinese). Chin J Diabetes 22(1):25–29

Yasuda T, Kaneto H, Kuroda A, Yamamoto T, Takahara M, Naka T, Miyashita K, Fujisawa K, Sakamoto F, Katakami N (2011) Subclinical hypothyroidism is independently associated with albuminuria in people with type 2 diabetes. Diabetes Res Clin Pract 94(3):e75–e77