Stefanowicz-Rutkowska Magdalena Maria, Matuszewski Wojciech, Gontarz-Nowak Katarzyna, Bandurska-Stankiewicz Elżbieta Maria
Clinic of Endocrinology, Diabetology and Internal Diseases, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, ul. Żołnierska 18 (Wojewódzki Szpital Specjalistyczny w Olsztynie, pok. 32), 10-957 Olsztyn, Poland.
Open Life Sci. 2021 Jun 21;16(1):611-619. doi: 10.1515/biol-2021-0064. eCollection 2021.
Autoimmune thyroid disease (AITD) is more common among diabetes mellitus (DM) patients and may impact its microvascular complications. The present study aimed to assess the relationship between AITD and the prevalence of diabetic kidney disease (DKD) in patients with diabetes mellitus type 1 (DM1). Anthropometric parameters, parameters of metabolic control of DM, thyreometabolic status, and the UACR were assessed. DKD was diagnosed if patients' UACR level was ≥30 mg/g or eGFR level was <60 mL/min. This study involved 144 patients with DM1 aged 36.2 ± 11.7 years: 49 men and 95 women. Significant differences in creatinine, eGFR, and UACR levels were found in patients with DKD. fT3 concentration was significantly lower among DKD patients. A significantly higher probability of DKD was found in DM1 patients with lower fT3 levels. Patients with DM1 and AITD had significantly lower creatinine levels than the control group. However, the study did not show any significant relationship between AITD and the occurrence of DKD in patients with DM1. Significantly lower fT3 concentrations in DKD patients may be caused by metabolic disorders in the course of DKD and require further cohort studies in a larger population of patients with DM1 and AITD.
自身免疫性甲状腺疾病（AITD）在糖尿病（DM）患者中更为常见，并且可能影响其微血管并发症。本研究旨在评估1型糖尿病（DM1）患者中AITD与糖尿病肾病（DKD）患病率之间的关系。评估了人体测量参数、DM的代谢控制参数、甲状腺代谢状态和尿白蛋白肌酐比值（UACR）。如果患者的UACR水平≥30 mg/g或估算肾小球滤过率（eGFR）水平<60 mL/min，则诊断为DKD。本研究纳入了144例年龄为36.2±11.7岁的DM1患者：49例男性和95例女性。在DKD患者中发现肌酐、eGFR和UACR水平存在显著差异。DKD患者的游离三碘甲状腺原氨酸（fT3）浓度显著降低。fT3水平较低的DM1患者发生DKD的概率显著更高。DM1合并AITD的患者肌酐水平显著低于对照组。然而，该研究未显示DM1患者中AITD与DKD的发生之间存在任何显著关系。DKD患者中fT3浓度显著降低可能是由DKD病程中的代谢紊乱所致，需要在更大规模的DM1和AITD患者群体中进行进一步的队列研究。
