Talwalkar Pradeep, Deshmukh Vaishali, Bhole Milind
Endocrinology, Talwalkar Diabetes Clinic, Mumbai, India.
Endocrinology, Shree Hospital, Pune, India.
Diabetes Metab Syndr Obes. 2019 Mar 20;12:369-376. doi: 10.2147/DMSO.S181470. eCollection 2019.
To determine the prevalence of hypothyroidism in patients with type 2 diabetes mel-litus (T2DM), hypertension, and both T2DM and hypertension (T2DM + hypertension) in India.
In this cross-sectional observational study, adult patients with an established or newly diagnosed T2DM, hypertension, and T2DM + hypertension who were visiting their physicians for a routine clinical checkup were enrolled across 29 sites in India. All the patient-related data were extracted from their medical records. The prevalence of hypothyroidism was evaluated by thyroid function test (levels of serum free thyroxine, free triiodothyronine, and thyroid-stimulating hormone [TSH]). The proportion of obese and overweight hypothyroid patients and dose of thyroxine in overt and subclinical hypothyroidism (SCH) cases (as per TSH values) were assessed during the study. The results were summarized by descriptive statistics.
A total of 1,508 patients (T2DM: 504; hypertension: 501; T2DM + hypertension: 503) were enrolled in the study. The prevalence of hypothyroidism in patients with T2DM, hypertension, and T2DM + hypertension was 24.8%, 33.5%, and 28.9%, respectively. The overall prevalence of hypothyroidism in T2DM (n=1,002) and hypertension (n=1,001) was 26.9% and 31.2%, respectively. The proportion of obese against overweight hypothyroid patients was higher in all indications (T2DM: 16.5% vs 3.4%; hypertension: 23.8% vs 5.4%; T2DM + hypertension: 21.5% vs 3.8%). A considerable proportion of patients with SCH was prescribed thyroxine in T2DM (61.5%), hypertension (61%), and T2DM + hypertension (62.5%) cases. The most commonly prescribed dose (mean) of thyroxine was 50 and 25 µg for overt hypothyroidism and SCH cases, respectively, in all cohorts.
There is a high (>20%) prevalence of hypothyroidism in patients with T2DM, hypertension, and T2DM + hypertension. Screening for hypothyroidism should be routinely considered for early diagnosis and effective management.
确定印度2型糖尿病(T2DM)患者、高血压患者以及同时患有T2DM和高血压(T2DM + 高血压)患者中甲状腺功能减退症的患病率。
在这项横断面观察性研究中,纳入了印度29个地点前来医生处进行常规临床检查的已确诊或新诊断为T2DM、高血压以及T2DM + 高血压的成年患者。所有与患者相关的数据均从其病历中提取。通过甲状腺功能测试(血清游离甲状腺素、游离三碘甲状腺原氨酸和促甲状腺激素[TSH]水平)评估甲状腺功能减退症的患病率。在研究期间,评估肥胖和超重甲状腺功能减退患者的比例以及显性和亚临床甲状腺功能减退症(SCH)病例(根据TSH值)中的甲状腺素剂量。结果通过描述性统计进行总结。
共纳入1508例患者(T2DM:504例;高血压:501例;T2DM + 高血压:503例)。T2DM患者、高血压患者以及T2DM + 高血压患者中甲状腺功能减退症的患病率分别为24.8%、33.5%和28.9%。T2DM(n = 1002)和高血压(n = 1001)患者中甲状腺功能减退症的总体患病率分别为26.9%和31.2%。在所有适应症中,肥胖甲状腺功能减退患者与超重甲状腺功能减退患者的比例更高(T2DM:16.5%对3.4%;高血压:23.8%对5.4%;T2DM + 高血压:21.5%对3.8%)。在T2DM(61.5%)、高血压(61%)和T2DM + 高血压(62.5%)病例中,相当比例的SCH患者被开具了甲状腺素。在所有队列中,显性甲状腺功能减退症和SCH病例最常用的甲状腺素处方剂量(均值)分别为50和25μg。
T2DM患者、高血压患者以及T2DM + 高血压患者中甲状腺功能减退症的患病率很高(>20%)。应常规考虑筛查甲状腺功能减退症以进行早期诊断和有效管理。