Abstract
Previous studies have suggested that even in euthyroid subjects, thyroid function may affect the risk factors of diabetic nephropathy (DN). Thus, we investigated the association between thyroid parameters and DN in euthyroid subjects with type 2 diabetes mellitus (T2DM). This was a cross-sectional study of 1,071 euthyroid subjects with T2DM (mean age of 61.90 ± 12.74 years; 622 men). Clinical factors, including levels of free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), thyroid autoantibodies, albumin excretion rate were measured. DN was present in 400 (37.35%) individuals. Patients with DN exhibited higher serum TSH and lower serum FT3 and FT4 levels than those without DN (P<0.05). After adjusting traditional risk factors of DN, the levels of both FT3 (per-SD increase, odds ratio [OR] 0.606 [95% confidence interval (CI), 0.481–0.762], P<0.001) and FT4 (per-SD increase, OR 0.944 [0.894–0.998], P = 0.040) were inversely correlated with DN. Meanwhile, we found that serum TSH levels were positively correlated with DN (per-SD increase, OR1.179 [1.033–1.346], P = 0.015). Low-to-normal thyroid hormones (THs) were also associated with the presence of macroalbuminuria. In conclusion, the relatively low levels of THs were significantly associated with DN in euthyroid subjects with T2DM.
Highlights
The prevalence of diabetes continues to increase significantly worldwide, especially in developing countries [1, 2]
In this hospital-based, cross-sectional study, we evaluated the associations between thyroid parameters and diabetic nephropathy (DN) in euthyroid subjects with type 2 diabetes mellitus (T2DM)
Our results showed that subjects with DN had lower free triiodothyronine (FT3) and free thyroxine (FT4) levels and higher thyroid-stimulating hormone (TSH) levels than those with normoalbuminuria
Summary
The prevalence of diabetes continues to increase significantly worldwide, especially in developing countries [1, 2]. This leads to an increase in the development of diabetic nephropathy (DN) [3]. As one of the main microvascular complications of diabetes, DN is the leading cause of end-stage renal disease (ESRD), which contributes to a significant increase in morbidity and mortality in diabetic patients [3]. Conventional therapies (such as smoking cessation, improved glycemic and blood pressure control) may not be able to fully terminate the progression of DN [4]. It is essential to identify the risk factors of DN and monitor its development or progression, which will improve the treatment efficacy and reduce individual and socioeconomic burdens of the disease
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