Zhongguo linchuang yanjiu (Nov 2023)
Association of subclinical thyroid dysfunction with diabetic kidney disease in type 2 diabetic patients
Abstract
Objective To investigate the correlation between subclinical thyroid dysfunction and diabetic kidney disease （DKD） in the patients with type 2 diabetes mellitus （T2DM）. Methods A retrospective analysis was performed on 276 T2DM patients treated in Jilin Province FAW General Hospital from January 2019 to March 2021, including 154 patients with DKD and 122 patients without DKD （control group）. The body mass index （BMI）, glycated hemoglobin （HbA1c）, serum total thyroxine （TT4）, total triiodothyronine （TT3）, free triiodothyronine （FT3）, free thyroxine （FT4） and thyroid-stimulating hormone （TSH） were measured and detected for all patients. The patients were further divided into normal thyroid function group （n=188）, subclinical hypothyroidism （SCHypo） group （n=63） and subclinical hyperthyroidism （SCHyper） group （n=25） according to thyroid function. The influencing factors of DKD was analyzed by multivariate logistic regression. Results Compared with non DKD patients, DKD patients had a longer course of disease and higher levels of BMI, fasting blood glucose, Cystatin C, serum uric acid, triglyceride, and TSH (P＜0.05). The incidence of DKD was 54.3% (102 cases) in the normal thyroid function group and 69.8% (44 cases) in the SCHypo group, the difference had statistical significance (χ2=4.711，P=0.038), in the SCHyper group, 32.0% (8 cases) showed a significant decrease compared to the normal thyroid function group (χ2=4.376，P=0.036). The logistic regression analysis showed that TSH(OR=0.908, 95%CI:0.838-0.985, P＜0.05) and SCHypo（OR=1.060, 95%CI:1.020-1.101, P＜0.05） were independent factors of DKD. Conclusion TSH level and SCHypo may be independent influencing factors of DKD in T2DM patients.
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