Relationship between Thyroid Function and Kidney Function in Patients with Type 2 Diabetes

الملخص EN

Purpose.

To determine if the TSH is related to estimated glomerular filtration rate (eGFR) in T2D patients without overt thyroid dysfunction.

Methods.

A cohort study of 5936 T2D patients was assessed for thyroid and kidney functions, in whom 248 with subclinical hyperthyroidism and 362 with subclinical hypothyroidism.

Serum creatinine and 24-hour urine albumin excretion (UAE) were collected.

Chronic kidney disease (CKD) was defined as eGFR < 60 ml/min/1.73 m2.

Results.

Compared with euthyroid subjects, the patients with subclinical hypothyroidism had lower eGFR (82.7 ± 22.4 vs.

90.5 ± 22.4 ml/min/1.73 m2, p<0.01), higher UAE (114 ± 278 vs.

88 ± 229 mg/24 h, p<0.05), and high incidence of CKD (16.0% vs.

10.1%, p<0.05).

The participants with a TSH level between 0.55 and 3.0 μIU/ml had a higher eGFR (91.4 ± 22.2 ml/min/1.73 m2) and a lower prevalence of CKD (9.5%) than those with higher TSH (3.01–4.78 μIU/ml, 85.6 ± 22.7 ml/min/1.73 m2, p<0.01 and 13.1%, p<0.01).

Linear logistic regression analysis showed that the eGFR was significantly negatively associated with TSH (OR: 0.519, 95% CI: 0.291–0.927, p<0.05), after adjustment of confounders.

Conclusion.

High TSH was independently associated with decreased eGFR in type 2 diabetes patients without overt thyroid dysfunction.

Our findings indicate that doctors who treat T2D patients should routinely measure the thyroid function.