Prevalence Of Thyroid Disorders In Patients With Type2Diabetes Mellitus

Objectives: To explore the prevalence of thyroid disease in patients with type2diabetes mellitus(T2DM) and investigate relevant factors that may cause thyroid disease,and to provide guidance for the clinical diagnosis and treatment.Methods: Four hundred and fifty patients with T2DM (men/women239/211) whohospitalized in department of Endocrinology of a university hospital in Dalian duringApril,2009to January,2013（men accounted for53%）. All the patients were in linewith the diagnostic criteria and standard for type of diabetes of1999World HealthOrganization with no history of thyroid disorders and no family history of thyroiddisease. The data such as thyroid function，HbA1C，thyroid autoantibody,blood lipid,thyroid ultrasound,BMI,HOMA-IR,were retrospective collected and statisticallyanalyzed.Results:1.The prevalence of thyroid nodules of patients with type2diabetesmellitus was found to be54.4%, and there was trend toward a higher prevalence in olderT2DM (2=8.551，P=0.014) and in longer duration of diabetes (2=17.829，P<0.001).Women had a higher nodule rate than men（2=7.269，P=0.026）. No influence of BMIand HbA1C was found on prevalence of thyroid nodules (P>0.05）.2.There were115patients who had abnormal thyroid function value, among them,8cases of hyperthyroidism(1.78%),40cases of hypothyroidism(8.89%),9cases ofsubclinical hyperthyroidism(2.0%)and58cases of subclinical hypothyroidism(12.89%)were included. The Prevalence of hypothyroidism and subclinical hypothyroidismsignificantly increased with age（2=28.135a，P＜0.01),and the prevalence alsoincreased with the increasing levels of HbA1C（2=21.423a，P=0.045).3.Among the patients with normal thyroid function, the prevalence of thyroid noduleswas53.5%, compared with male patients(50.8%), the prevalence of thyroid nodules infemale patients(57.7%)was significantly higher(2=2.398a，P=0.301).There were29 cases in single antibody-positive subgroup (ATG/ATPO), eight were found to havenodules, and4cases in both antibody-positive subgroup, two was found to have nodules. No statistically significant difference has been found among the three subgroups（2=1.857b,P=0.762）.Among the three sub-groups,there has no statisticallysignificant difference in the level of FT4(F=0.483, P=0.618), sTSH (F=0.069, P=0.934)and HbA1C (F=0.019, P=0.981).4.Among the patients with normal thyroid function, Stepwise Logistic regressiveanalysis found fasting glucose and sTSH (OR=1.552,95％CI:1.166-2.066) wereassociated with incidence of thyroid nodules.