Pramanik Subhodip, Ghosh Sujoy, Mukhopadhyay Pradip, Bhattacharjee Rana, Mukherjee Bidisha, Mondal Samim Ali, Ghosh Ipsita, Bari Ranajit, Chowdhury Subhankar
Department of Endocrinology, IPGMER, Kolkata, West Bengal, India.
Indian J Endocrinol Metab. 2018 Jan-Feb;22(1):112-115. doi: 10.4103/ijem.IJEM_572_17.
Type 2 diabetes mellitus and thyroid dysfunction (TD) are two major public health endocrine problem, but the prevalence of TD and iodine status in patients with T2 DM in India is less studied. The study objective was to explore the prevalence of TD and to evaluate iodine health in type 2 diabetes patients attending a tertiary care center in Eastern India.
Consecutive 100 patients with diabetes attending outpatient department were evaluated clinically and biochemically (thyrotropin [TSH], free thyroxine, anti-TPO antibody, and urinary iodine). We excluded pregnant women or patients taking drugs that can alter thyroid function. Subclinical hypothyroid and overt hypothyroidism were diagnosed as per standard definitions.
Out of 100 patients were analyzed, 51 (51%) were male. Mean (±standard deviation) age was 45.4 ± 11.2 years, body mass index 24.1 ± 4.28 kg/m, and duration of diabetes 7.76 ± 5.77 years. The prevalence of subclinical hypothyroidism and overt hypothyroidism was 23/100 (23%) and 3/100 (3%), respectively. Thyroid autoantibody was positive in 13 (13.1%) patients. All patients were iodine sufficient. A trend toward increased neuropathy ( = 0.45) and nephropathy ( = -0.29) was associated with rising TSH.
Almost one in four people living with diabetes are suffering from TD. Thus, routine screening should be implemented. Salt iodination program is a huge success in this part of the country.
2型糖尿病和甲状腺功能障碍(TD)是两个主要的公共卫生内分泌问题,但印度2型糖尿病患者中TD的患病率和碘状态的研究较少。本研究的目的是探讨TD的患病率,并评估印度东部一家三级医疗中心的2型糖尿病患者的碘健康状况。
对连续100例门诊糖尿病患者进行临床和生化评估(促甲状腺激素[TSH]、游离甲状腺素、抗甲状腺过氧化物酶抗体和尿碘)。我们排除了孕妇或正在服用可改变甲状腺功能药物的患者。根据标准定义诊断亚临床甲状腺功能减退和显性甲状腺功能减退。
在分析的100例患者中,51例(51%)为男性。平均(±标准差)年龄为45.4±11.2岁,体重指数为24.1±4.28kg/m,糖尿病病程为7.76±5.77年。亚临床甲状腺功能减退和显性甲状腺功能减退的患病率分别为23/100(23%)和3/100(3%)。13例(13.1%)患者甲状腺自身抗体呈阳性。所有患者碘充足。神经病变(=0.45)和肾病(=-0.29)增加的趋势与TSH升高有关。
几乎四分之一的糖尿病患者患有TD。因此,应实施常规筛查。食盐碘化计划在该国这一地区取得了巨大成功。