Relationship between subclinical hypothyroidism and chronic complications of diabetes mellitus / 中华老年医学杂志

ABSTRACT

Objective To explore the impacts of subclinical hypothyroidism (SCH) on chronic complications of type 2 diabetes mellitus. Methods Totally 448 patients with type 2 diabetes were divided into diabetes plus SCH group (n=148) and control group (T2DM without SCH,n=300).The patient's general information,past medical history,chronic complications of diabetes including diabetic nephropathy ( DN ), diabetic retinopathy ( DR), diabetic peripheral neuropathy ( DPN ),peripheral arterial disease (PAD),diabetic foot (DF),ancillary and laboratory test results were analyzed. Results The age,duration of diabetes,incidence of coronary heart disease and levels of fasting C-peptide,total cholesterol,triacylglycerol,lipoprotein (a),hs-CRP,LDL-C,UAER and thyroid stimulating hormone (TSH) [(6.8 ± 3.5) mIU/L vs. (2.1 ± 1.3) mlU/L], antithyroidperoxidase antibody (TPO-Ab) [(253.6 ± 287.1 ) kU/L vs. (46.2 ± 80.7)] kU/L and thyroglobulin antibodies (TG-Ab) [( 57.8 ± 83.5 ) kU/L vs. ( 39.4 ± 45.3 ) kU/L] were significantly higher,but the ankle brachial index(ABI) and E/A value were lower in diabetes plus SCH group than in control group (P＜0.01 or 0.05).The prevalences of DN( 63％ vs.46％,P＜0.01),DR (40％vs.29％,P＜0.05),DPN (34％ vs.24％,P＜0.05),PAD (51％ vs.38％,P＜0.05) and DF (22％ vs.12％,P＜0.01) were higher in diabetes plus SCH group than in control group.Logistic regression analysis demonstrated that high level of TSH was independent risk factor for DN(β=0.1273,OR =1.1361) and DF (β=0.1153, OR =1.1222). Conclusions Subclinical hypothyroidism is an independent risk factor for diabetic nephropathy and diabetic foot,so the elderly with longer duration of diabetes should regularly be checked in thyroid ffunction to early find hypothyroidism.