Department of Internal Medicine, Specialized Medical Hospital, Mansoura University Faculty of Medicine, Mansoura, Egypt.
Department of Clinical Pathology, Specialized Medical Hospital, Mansoura University Faculty of Medicine, Mansoura, Egypt.
Diabetes Metab J. 2013 Dec;37(6):450-7. doi: 10.4093/dmj.2013.37.6.450. Epub 2013 Dec 12.
Recent evidence has suggested an association between subclinical hypothyroidism (SCH) and microalbuminuria in patients with type 2 diabetes. However, whether SCH is related to microalbuminuria among subjects with prediabetes has not been studied. Thus, we evaluated the association between SCH and microalbuminuria in a cohort of prediabetic Egyptian adults.
A total of 147 prediabetic subjects and 150 healthy controls matched for age and sex were enrolled in this study. Anthropometric measurements, plasma glucose, lipid profile, homeostasis model assessment of insulin resistance (HOMA-IR), thyroid stimulating hormone (TSH), free thyroxine, triiodothyronine levels, and urinary albumin-creatinine ratio (UACR) were assessed.
The prevalence of SCH and microalbuminuria in the prediabetic subjects was higher than that in the healthy controls (16.3% vs. 4%, P<0.001; and 12.9% vs. 5.3%, P=0.02, respectively). Prediabetic subjects with SCH were characterized by significantly higher HOMA-IR, TSH levels, UACR, and prevalence of microalbuminuria than those with euthyroidism. TSH level was associated with total cholesterol (P=0.05), fasting insulin (P=0.01), HOMA-IR (P=0.01), and UACR (P=0.005). UACR was associated with waist circumference (P=0.01), fasting insulin (P=0.05), and HOMA-IR (P=0.02). With multiple logistic regression analysis, SCH was associated with microalbuminuria independent of confounding variables (β=2.59; P=0.01).
Our findings suggest that prediabetic subjects with SCH demonstrate higher prevalence of microalbuminuria than their non-SCH counterparts. SCH is also independently associated with microalbuminuria in prediabetic subjects. Screening and treatment for SCH may be warranted in those patients.
最近的证据表明，亚临床甲状腺功能减退症（SCH）与 2 型糖尿病患者的微量白蛋白尿之间存在关联。然而，尚未研究 SCH 是否与糖尿病前期患者的微量白蛋白尿有关。因此，我们评估了一批埃及糖尿病前期成年人中 SCH 与微量白蛋白尿之间的关系。
共纳入 147 例糖尿病前期患者和 150 例年龄和性别相匹配的健康对照者进行这项研究。评估了人体测量学指标、血糖、血脂谱、胰岛素抵抗的稳态模型评估（HOMA-IR）、促甲状腺激素（TSH）、游离甲状腺素、三碘甲状腺原氨酸水平和尿白蛋白/肌酐比值（UACR）。
糖尿病前期患者中 SCH 和微量白蛋白尿的患病率高于健康对照组（16.3%比 4%，P<0.001；12.9%比 5.3%，P=0.02）。SCH 的糖尿病前期患者的 HOMA-IR、TSH 水平、UACR 和微量白蛋白尿患病率显著高于甲状腺功能正常者。TSH 水平与总胆固醇（P=0.05）、空腹胰岛素（P=0.01）、HOMA-IR（P=0.01）和 UACR（P=0.005）相关。UACR 与腰围（P=0.01）、空腹胰岛素（P=0.05）和 HOMA-IR（P=0.02）相关。多元逻辑回归分析显示，SCH 与混杂因素独立相关（β=2.59；P=0.01）。
我们的研究结果表明，SCH 的糖尿病前期患者微量白蛋白尿的患病率高于非 SCH 患者。SCH 也与糖尿病前期患者的微量白蛋白尿独立相关。在这些患者中，可能需要对 SCH 进行筛查和治疗。
