Association between Thyroid Hormone Levels and Diabetic Kidney Disease in Euthyroid Patients with Type 2 Diabetes

Jian Zou,Juan Zhang,Haixu Chen,Zeping Li,Chao Xu,Yi Zhang,Chao Yang,Yonghong Xie,Jiajia Zhai,Min Shi,Feng Tian,Xiaomiao Li,Wenjuan Li

doi:10.1038/s41598-018-22904-7

Abstract

The association between normal thyroid function and diabetic kidney disease (DKD) has gained increasing attention. The present study evaluated the relationship between normal thyroid hormone levels and DKD in type 2 diabetes mellitus (T2DM) patients. A total of 862 type 2 diabetes patients were enrolled in this cross-sectional study in Xi’an, Shaanxi Province, China. The subjects were evaluated for anthropometric measurements, thyroid function and DKD. Of 862 patients, 246 (28.5%) suffered from DKD, and the prevalence of DKD did not differ between men and women. The prevalence of DKD showed a significantly decreasing trend across the quartiles based on free triiodothyronine (FT3) levels (41.1%, 30.6%, 23.8%, and 18.9%, P < 0.001). In comparison with all participants categorized in the first FT3 quartile group (FT3-Q1) (<4.380), the adjusted odds ratio of DKD in the second FT3 quartile group (FT3-Q2), the third FT3 quartile group (FT3-Q3), and the fourth FT3 quartile group (FT3-Q4) were 0.655(95%CI: 0.406–1.057), 0.493(95%CI: 0.299–0.813), 0.406(0.237–0.697) (P < 0.05). Also, similar results were observed in men. Conversely, none of the FT3 groups was associated with DKD in women. The present study showed that FT3 within normal range was negatively correlated with DKD in T2DM patients.

Highlights

It is unclear whether the normal thyroid hormone levels and diabetic kidney disease (DKD) are correlated in type 2 diabetes (T2DM) patients
type 2 diabetes mellitus (T2DM) was defined as an fasting plasma glucose (FPG) level ≥126 mg/dL (7.0 mmol/L), or oral glucose tolerance test ≥200 mg/dL (11.1 mmol/L), or HbA1c ≥48 mmol/mol (6.5%), or a history of T2DM based on the American Diabetes Association (ADA) 2013 criteria[12]
Compared to the non-DKD patients, those with DKD were older with a prolonged duration of diabetes, higher prevalence of hypertension, higher angiotensin Receptor Blocker (ARB) or angiotensin converting enzyme inhibitors (ACEI) medication, higher use of insulin, higher WHtR, systolic blood pressure (SBP), diastolic blood pressure (DBP), HbA1c, FPG, TG and lower Hemoglobin (HGB)

Summary

Introduction

DKD had been extended to the areas of normal thyroid function. It is unclear whether the normal thyroid hormone levels and DKD are correlated in type 2 diabetes (T2DM) patients. The present cross-sectional study investigated whether serum thyroid hormone concentrations within normal range, as well as thyroid peroxidase antibody (TPO-Ab) levels, are related to the prevalence of DKD among T2DM inpatients

Methods

Results

Conclusion