Association between subclinical hypothyroidism and diabetic nephropathy in patients with type 2 diabetes mellitus

作者：Furukawa Shinya^*; Yamamoto Shin; Todo Yasuhiko; Maruyama Kotatsu; Miyake Teruki; Ueda Teruhisa; Niiya Tetsuji; Senba Takatoshi; Torisu Masamoto; Kumagi Teru; Miyauchi Syozo; Sakai Takenori; Minami Hisaka; Miyaoka Hiroaki; Matsuura Bunzo; Hiasa Yoichi; Onji Morikazu; Tanigawa Takeshi

来源：Endocrine Journal, 2014, 61(10): 1011-1018.

DOI：10.1507/endocrj.EJ14-0206

• Dyslipidemia
• Kidney
• Metabolic disease
• Microvascular disease
• Thyroid-stimulating hormone

Subclinical hypothyroidism (SCH) has been associated with type 2 diabetes mellitus. However, it is unknown whether common complications of type 2 diabetes, such as diabetic nephropathy, are also present with SCH. Here, we investigated the association between SCH and diabetic nephropathy among Japanese patients with type 2 diabetes mellitus. In this multicenter cross-sectional study, we recruited 414 such patients who had no previous history of thyroid disease. Serum thyroid hormone levels and the urinary albumin:creatinine ratio were measured. SCH was defined as an elevated thyroid-stimulating hormone (TSH) level (%26gt;4.0 mIU/L), and diabetic nephropathy was defined as urinary albumin/creatinine ratio %26gt;= 300 mg/g. The prevalence of SCH was 8.7% (n = 36) among patients with type 2 diabetes mellitus. The SCH group had a higher prevalence of dyslipidemia (p = 0.008) and diabetic nephropathy (p = 0.014) than the euthyroid group. Multivariate analysis identified significant positive associations between diabetic nephropathy and SCH (odds ratio [OR], 3.51; 95% confidence interval [CI], 1.10-10.0; p = 0.034), hypertension (OR, 4.56; 95% CI, 1.69-14.7; p = 0.001), and smoking (OR, 3.02; 95% CI, 1.14-7.91;p = 0.026). SCH may be independently associated with diabetic nephropathy in Japanese patients with type 2 diabetes mellitus.

• 出版日期2014-10