Association between thyroid function and diabetic nephropathy in euthyroid subjects with type 2 diabetes mellitus: a cross-sectional study in China

Abstract

// Jian Wang 1, * , Huiqin Li 1, * , Mingjuan Tan 2, * , Gu Gao 1 , Ying Zhang 1 , Bo Ding 1 , Xiaofei Su 1 , Xiaocen Kong 1 and Jianhua Ma 1 1 Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210012, China 2 Department of Clinical Laboratory, Nanjing First Hospital, Nanjing Medical University, Nanjing 210012, China * These authors have contributed equally to this study Correspondence to: Jianhua Ma, email: majianhua196503@126.com Xiaocen Kong, email: kongxiaocen@njmu.edu.cn Keywords: thyroid hormones; free triiodothyronine; free thyroxine; thyroid-stimulating hormone; type 2 diabetes mellitus Received: June 09, 2017      Accepted: February 28, 2018      Published: January 04, 2019 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.