Analysis Of The Relationship Between Subclinical Hypothyroidism And Diabetic Nephropathy

Objective To investigate the prevalence of subclinical hypothyroidism in diabetic patients and their association with diabetic nephropathy.Methods Using Reaction to study the database of Gansu province,the results of this study were analyzed in 2277 patients with diabetes mellitus,according to whether complicated with subclinical hypothyroidism divided into subclinical hypothyroidism group and normal thyroid function group.All patients completed a standard questionnaire survey,height,weight,waist circumference(WC),hip circumference(HC),systolic blood pressure(SBP)and diastolic blood pressure(DBP)were measured,body mass index(BMI),waist to hip ratio(W/H)and glomerular filtration rate(e GFR)were calculated,fasting blood glucose(FBG),two hours of postprandial blood glucose(2h PG),glycosylated hemoglobin(Hb A1C),urinary albumin(Alb),urinary creatinine(CR),serum creatinine(Scr),triglycerides(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),serum thyroid stimulating hormone(TSH),three iodine thyroid(T3),four iodine thyroid(T4)and other related biochemical indexes were measured.The prevalence of subclinical hypothyroidism and diabetic nephropathy in the diabetic population was analyzed and the correlation between hypothyroidism and diabetic nephropathy in diabetic population was investigated.Results 1.A total of 2277 patients were included in the study,There were 900 males(39.5%)and females(1377)(60.5%).All participants aged 40-75 years and the mean year of them is 61.5±8.0 years old,The mean BMI of them is(24.9 + 3.6)kg/m2.The male waist and hips larger,DBP,FPG,Hb A1 c,Scr,e GFR level is higher,the female TC,LDL-C,HDL-C,TSH,T3 level higher,the difference was statistically significant(all p <0.05).In the general population,the prevalence rate of hypertension,dyslipidemia,subclinical hypothyroidism and diabetic nephropathy were 27.7%,15.3%,30.4%,and 16.6%,Among them,the prevalence rates of subclinical hypothyroidism and diabetic nephropathy in men and women were 21.7%,36.2% and 16.2%,16.8% respectively.2.The prevalence of subclinical hypothyroidism in women is higher than that in men(36.2% VS 21.7%,p<0.05).The e GFR,T3,and T4 in the hypothyroid group were lower than those in the normal thyroid function group,TSH was higher than that in the normal group,the difference was statistically significant(p<0.05)The e GFR,T3,and T4 in the hypothyroid group were lower than those in the normal thyroid function group,TSH was higher than that in the normal group,the difference was statistically significant(p <0.05).The prevalence of diabetic nephropathy in the subclinical hypothyroidism group was higher than that in the normal group(17.6% VS 16.2%,p<0.05).3.The age of diabetic nephropathy group was higher,BMI,SBP,DBP,Hb A1 c,ACR,FBG,Scr,TG,TSH were higher than normal proteinuria group,e GFR was lower than normal proteinuria group,the difference was statistically significant(p <0.05).The prevalence of subclinical hypothyroidism in the nephrotic group was higher than that in the normal proteinuria group(32.3% VS 30.1%,p<0.05).4.One-Way ANOVA analysis showed that : Different levels of urinary albumin,o macroalbuminuria group TSH concentration level(6.00±6.23 u IU/m L)than microalbuminuria group(3.66±2.81 u IU/m L)and normal albuminuria group(3.50±2.71 u IU/m L),microalbuminuria group than in normal albuminuria group(all p <0.05).5.The normal group of thyroid function was set as the reference group,diabetic nephropathy as dependent variable,and Logistic regression analysis showed: When the confounding factors were not adjusted,there is no significant correlation between subclinical hypothyroidism and diabetic nephropathy in diabetic patients,gradually adjusted age,WC,,there is no significant correlation between subclinical hypothyroidism and diabetic nephropathy in diabetic patients(p>0.05),continue to adjust the confounders(FBG,2h PG,Hb A1 C,SBP,DBP,TG,TC,LDL-C,HDL-C)after the adjustment,there is no significant correlation between subclinical hypothyroidism and diabetic nephropathy in diabetic patients(all p>0.05).Conclusions The prevalence of subclinical hypothyroidism in women with diabetes was higher in men;there is no significant correlation between subclinical hypothyroidism and diabetic nephropathy in diabetic patients.