| Objective:To compare the relation between thyroid hormones and DKD,DR in type 2 diabetes.To explore the effect of thyroid hormones on DKD and DR.Methods:A retrospective study was performed in our hospital.The following information was obtained from the medical records: duration of diabetes,previous history,SBP,DBP,fundus photography,FPG,HbA1 c,FT3,FT4,TSH,TPO-Ab,ACR etc.DKD was diagnosed according to the 2012 KDOQI guidelines and DKD expert consensus in China(2014 edition);DR was diagnosed according to retinal photography.SCH refer to the guidelines of adult thyroid dysfunction treatment(2012 edition).A two-tailed value of <0.05 was considered statistically significant.Data were analyzed using SPSS version 19.0.Results:1 Results of the correlation between thyroid hormones and DKD1.1 924 patients were included in this part of study,with the mean age of 54.09 ± 11.69 years and the average BMI of 25.90 ± 3.38 Kg / m2.Among these patients,862 cases were normal thyroid function and 62(6.7%)were SCH.The comparison of age,gender,HbA1 c,FPG,HGB,Cysc,eGFR,TC and smoking had statistically significance between euthyroidism group and SCH group(P <0.05).The results also indicated that the prevalence of DKD was significant between groups(P < 0.05).1.2 The odds ratio(95%CI)of the DKD for SCH in no adjustment mode and adjustment age,gender etc.factors was 2.348(1.396-3.947),1.884(1.032-3.438)(P = 0.001,0.039),respectively.1.3 In 862 euthyroid patients,compared with non-DKD patients,DKD patients had older age,longer duration of diabetes,higher prevalence of hypertension,higher rate of insulin treatment,higher SBP,DBP,HbA1 c,FPG and TG(P < 0.05).DKD patients also experienced lower rate of taking metformin,lower HGB and FT3(P < 0.05).1.4 In 862 euthyroid patients,TSH was divided into two groups by <2.5 and ≥ 2.5;FT3 and FT4 were divided into four groups according to the quartiles and TPO-Ab was divided into negative and positive groups.The prevalence of DKD showed a significant decreasing trend across the fourth tertiles based on FT3(Q1,Q2,Q3,Q4)(41.1%,30.6%,23.8% and 18.9%,P < 0.001).There was no significance in the prevalence of DKD between FT4,TSH and TPO-Ab groups.1.5 Compared with the lowest group FT3,the odds ratio(95%CI)of the DKD for increasing quartiles of FT3 in no adjustment mode and adjustment age,gender etc.factors was 0.632(0.425-0.939),0.447(0.295-0.680),0.333(0.215-0.516)(P = 0.023,P < 0.001,P < 0.001);0.605(0.382-0.957),0.516(0.317-0.838),0.471(0.280-0.792)(P = 0.032,P = 0.008,P = 0.005),respectively.2 Results of the correlation between thyroid hormones and DR2.1 676 patients were included in this part of study,with the mean age of 52.82±10.57 years and the mean BMI of 25.81±3.36 Kg/m2。Among these patients,633 cases were normal thyroid function and 43(6.4%)were SCH.The comparison of age,gender,smoking,WHtR,TC and HGB had statistically significance between euthyroidism group and SCH group(P < 0.05).2.2 The odds ratio(95% CI)of the DR for SCH in no adjustment mode and adjustment age,gender etc.factors was 0.951(0.502-1.801),0.620(0.287-1.340)(P = 0.878,P = 0.224),respectively.2.3 In euthyroid patients,compared,DR patients had older age,longer duration of diabetes,more female,higher prevalence of hypertension,higher rate of insulin treatment,higher SBP(P < 0.05).DR patients had lower HGB and FT3 than non-DR patients(P < 0.05).2.4 In euthyroid patients,TSH was divided into two groups by <2.5 and ≥ 2.5;FT3 and FT4 were divided into four groups according to the quartiles and TPO-Ab was divided into negative and positive groups.The prevalence of DR showed a significant decreasing trend across the fourth tertiles based on FT3(Q1,Q2,Q3,Q4)(56.7%,42.5%,33.1%,23.8%,P < 0.001).There was no significance in the prevalence of DR between FT4,TSH and TPO-Ab groups.2.5 Compared with the lowest group FT3,the odds ratio(95% CI)of the DKD for increasing quartiles of FT3 in no adjustment mode and adjustment age,gender etc.factors was 0.563(0.358-0.885),0.378(0.235-0.608),0.238(0.144-0.392)(P = 0.013,P < 0.001,P < 0.001);0.587(0.340-1.012),0.458(0.258-0.813),0.368(0.201-0.673),(P = 0.055、P = 0.008、P = 0.001),respectively.Conclusions:1 SCH in type 2 diabetic patients is positively associated with DKD,but the present study found SCH in type 2 diabetic patients is not associated with DR.2 Serum FT3 levels are negatively associated with DKD and DR in euthyroid patients with type 2 diabetes,independent of traditional risk factors. |
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