Rai Srinidhi, Kumar J Ashok, K Prajna, Shetty Shobith Kumar, Rai Tirthal, Begum Mohamedi
Tutor, Department of Biochemistry, AJ Institute of Medical Sciences , Kuntikana, Mangalore 575004, Karnataka, India .
J Clin Diagn Res. 2013 Aug;7(8):1583-5. doi: 10.7860/JCDR/2013/6216.3299. Epub 2013 Aug 1.
Diabetic patients have higher prevalence of thyroid disorders than the general population which may have an influence on diabetic management. The present study compared the levels of thyroid hormones, serum creatinine, glycated haemoglobin and urine microalbumin between type 2 diabetics without any complications, type 2 diabetics with nephropathy and age and sex matched normal controls.
The mean serum T3 level in type 2 diabetics without any complications was 91.27 ± 14.56 ng/dl , in type 2 diabetics with nephropathy was 88.5320 ± 30.87 ng/dl and in controls was 134.98 ± 28.55 ng/dl. The mean serum T4 level in type 2 diabetics without any complications was 7.73 ± 1.42 μg/dl, in type 2 diabetics with nephropathy was 7.25 ± 2.72 μg/dl and in controls was 8.61 ± 1.73 μg/dl. The mean serum TSH level in type 2 diabetics without any complications was 3.99 ± 1.87 μIU/ml, in type 2 diabetics with nephropathy was 4.27 ± 1.62 μIU/ml and in controls was 2.07 ± 1.09 μIU/ml. Correlations between T3, T4, TSH with serum creatinine, glycated haemoglobin were not statistically significant in type 2 diabetes without any complications and diabetic nephropathy. We found a statistically significant correlation between T3 and urine microalbumin in patients with diabetic nephropathy.
Failure to recognize the presence of abnormal thyroid hormone levels may be a primary cause of poor management of diabetes mellitus type 2. Therefore there is a need for the routine assay of thyroid hormones in type 2 diabetics and diabetic nephropathy in order to improve the quality of life and reduce the morbidity.
糖尿病患者甲状腺疾病的患病率高于普通人群,这可能会影响糖尿病的管理。本研究比较了无任何并发症的2型糖尿病患者、患有肾病的2型糖尿病患者以及年龄和性别匹配的正常对照组之间的甲状腺激素水平、血清肌酐、糖化血红蛋白和尿微量白蛋白水平。
无任何并发症的2型糖尿病患者的平均血清T3水平为91.27±14.56 ng/dl,患有肾病的2型糖尿病患者为88.5320±30.87 ng/dl,对照组为134.98±28.55 ng/dl。无任何并发症的2型糖尿病患者的平均血清T4水平为7.73±1.42 μg/dl,患有肾病的2型糖尿病患者为7.25±2.72 μg/dl,对照组为8.61±1.73 μg/dl。无任何并发症的2型糖尿病患者的平均血清TSH水平为3.99±1.87 μIU/ml,患有肾病的2型糖尿病患者为4.27±1.62 μIU/ml,对照组为2.07±1.09 μIU/ml。在无任何并发症的2型糖尿病和糖尿病肾病患者中,T3、T4、TSH与血清肌酐、糖化血红蛋白之间的相关性无统计学意义。我们发现糖尿病肾病患者的T3与尿微量白蛋白之间存在统计学意义的相关性。
未能识别甲状腺激素水平异常可能是2型糖尿病管理不善的主要原因。因此,有必要对2型糖尿病患者和糖尿病肾病患者进行甲状腺激素的常规检测,以提高生活质量并降低发病率。