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Erschienen in: Endocrine 1/2017

07.09.2016 | Original Article

The prevalence and determinants of hypothyroidism in hospitalized patients with type 2 diabetes mellitus

verfasst von: Fei Song, Cuiping Bao, Meiyu Deng, Hui Xu, Meijuan Fan, Stéphanie Paillard-Borg, Weili Xu, Xiuying Qi

Erschienen in: Endocrine | Ausgabe 1/2017

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Abstract

The purpose of this study was to investigate the prevalence of hypothyroidism among hospitalized patients with type 2 diabetes mellitus and its related factors, and to assess the prevalence of macrovascular and microvascular diseases among type 2 diabetes mellitus inpatients with hypothyroidism and euthyroidism. A total of 1662 type 2 diabetes mellitus inpatients hospitalized at the Metabolic Diseases Hospital, Tianjin Medical University from 1 January 2008 to 1 March 2013 were included in this study. Information on demographic and anthropometric factors and additional variables related to hypothyroidism were collected from medical records. Prevalence rates were calculated and standardized using direct method based on the age-specific and sex-specific structure of all participants. Data were analyzed using binary logistic regression with adjustment for potential confounders. The prevalence of hypothyroidism among type 2 diabetes mellitus inpatients was 6.8 %, and 77.0 % of the patients with hypothyroidism had subclinical hypothyroidism. The prevalence of hypothyroidism increased with age, and was higher in women (10.8 %) than in men (3.4 %). Older age (odds ratio, 1.74; 95 % confidence interval, 1. 05 to 2.89), female gender (odds ratio, 2.02; 95 % confidence interval, 1.05 to 3.87), and positive thyroid peroxidase antibody (odds ratio, 4.99; 95 % confidence interval, 2.83 to 8.79) were associated with higher odds of hypothyroidism among type 2 diabetes mellitus inpatients. The type 2 diabetes mellitus inpatients with hypothyroidism had higher prevalence of cerebrovascular diseases than those with euthyroidism after adjustment for age and gender. The prevalence of hypothyroidism among type 2 diabetes mellitus inpatients was 6.8 %, and most patients had subclinical hypothyroidism. Older age, female gender, and positive thyroid peroxidase antibody could be indicators for detecting hypothyroidism in type 2 diabetes mellitus inpatients.
Literatur
3.
Zurück zum Zitat S.M. Ghazali, F.M. Abbiyesuku, Thyroid dysfunction in type 2 diabetics seen at the University College Hospital, Ibadan, Nigeria. Niger. J. Physiol. Sci. 25(2), 173–179 (2010)PubMed S.M. Ghazali, F.M. Abbiyesuku, Thyroid dysfunction in type 2 diabetics seen at the University College Hospital, Ibadan, Nigeria. Niger. J. Physiol. Sci. 25(2), 173–179 (2010)PubMed
4.
Zurück zum Zitat B. Song, Thyroid diaease epidemiology among Nanjing community population (article in Chinese). Master's Thesis, Nanjing Medical University (2011) B. Song, Thyroid diaease epidemiology among Nanjing community population (article in Chinese). Master's Thesis, Nanjing Medical University (2011)
5.
Zurück zum Zitat G.J. Canaris, N.R. Manowitz, G. Mayor, E.C. Ridgway, The Colorado thyroid disease prevalence study. Arch. Int. Med. 160(4), 526–534 (2000)CrossRef G.J. Canaris, N.R. Manowitz, G. Mayor, E.C. Ridgway, The Colorado thyroid disease prevalence study. Arch. Int. Med. 160(4), 526–534 (2000)CrossRef
6.
Zurück zum Zitat N. Knudsen, T. Jorgensen, S. Rasmussen, E. Christiansen, H. Perrild, The prevalence of thyroid dysfunction in a population with borderline iodine deficiency. Clin. Endocrinol. 51(3), 361–367 (1999)CrossRef N. Knudsen, T. Jorgensen, S. Rasmussen, E. Christiansen, H. Perrild, The prevalence of thyroid dysfunction in a population with borderline iodine deficiency. Clin. Endocrinol. 51(3), 361–367 (1999)CrossRef
7.
Zurück zum Zitat H.E. Tamez-Perez, E. Martinez, D.L. Quintanilla-Flores, A.L. Tamez-Pena, H. Gutierrez-Hermosillo, E. Diaz de Leon-Gonzalez, The rate of primary hypothyroidism in diabetic patients is greater than in the non-diabetic population. An observational study. Med. Clin. 138(11), 475–477 (2012). doi:10.1016/j.medcli.2011.08.009 CrossRef H.E. Tamez-Perez, E. Martinez, D.L. Quintanilla-Flores, A.L. Tamez-Pena, H. Gutierrez-Hermosillo, E. Diaz de Leon-Gonzalez, The rate of primary hypothyroidism in diabetic patients is greater than in the non-diabetic population. An observational study. Med. Clin. 138(11), 475–477 (2012). doi:10.​1016/​j.​medcli.​2011.​08.​009 CrossRef
8.
9.
Zurück zum Zitat R. Zhao, A preliminary study on the function of thyroid in patients with type 2 diabetes (article in Chinese). Master's Thesis, Ningxia Medical University (2013) R. Zhao, A preliminary study on the function of thyroid in patients with type 2 diabetes (article in Chinese). Master's Thesis, Ningxia Medical University (2013)
10.
Zurück zum Zitat M. Al-Geffari, N.A. Ahmad, A.H. Al-Sharqawi, A.M. Youssef, D. Alnaqeb, K. Al-Rubeaan, Risk factors for thyroid dysfunction among type 2 diabetic patients in a highly diabetes mellitus prevalent society. Int. J. Endocrinol. 2013, 417920 (2013). doi:10.1155/2013/417920 CrossRefPubMedPubMedCentral M. Al-Geffari, N.A. Ahmad, A.H. Al-Sharqawi, A.M. Youssef, D. Alnaqeb, K. Al-Rubeaan, Risk factors for thyroid dysfunction among type 2 diabetic patients in a highly diabetes mellitus prevalent society. Int. J. Endocrinol. 2013, 417920 (2013). doi:10.​1155/​2013/​417920 CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat G. Chen, J. Wu, Y. Lin, B. Huang, J. Yao, Q. Jiang, J. Wen, L. Lin, Associations between cardiovascular risk, insulin resistance, beta-cell function and thyroid dysfunction: a cross-sectional study in She ethnic minority group of Fujian Province in China. Eur. J. Endocrinol. 163(5), 775–782 (2010). doi:10.1530/EJE-10-0710 CrossRefPubMed G. Chen, J. Wu, Y. Lin, B. Huang, J. Yao, Q. Jiang, J. Wen, L. Lin, Associations between cardiovascular risk, insulin resistance, beta-cell function and thyroid dysfunction: a cross-sectional study in She ethnic minority group of Fujian Province in China. Eur. J. Endocrinol. 163(5), 775–782 (2010). doi:10.​1530/​EJE-10-0710 CrossRefPubMed
12.
Zurück zum Zitat J.J. Diez, P. Iglesias, Spontaneous subclinical hypothyroidism in patients older than 55 years: an analysis of natural course and risk factors for the development of overt thyroid failure. J. Clin. Endocrinol. Metab. 89(10), 4890–4897 (2004). doi:10.1210/jc.2003-032061 CrossRefPubMed J.J. Diez, P. Iglesias, Spontaneous subclinical hypothyroidism in patients older than 55 years: an analysis of natural course and risk factors for the development of overt thyroid failure. J. Clin. Endocrinol. Metab. 89(10), 4890–4897 (2004). doi:10.​1210/​jc.​2003-032061 CrossRefPubMed
14.
Zurück zum Zitat A. Ishay, I. Chertok-Shaham, I. Lavi, R. Luboshitzky, Prevalence of subclinical hypothyroidism in women with type 2 diabetes. Med. Sci. Monit. 15(4), CR151–155 (2009)PubMed A. Ishay, I. Chertok-Shaham, I. Lavi, R. Luboshitzky, Prevalence of subclinical hypothyroidism in women with type 2 diabetes. Med. Sci. Monit. 15(4), CR151–155 (2009)PubMed
15.
Zurück zum Zitat A. Papazafiropoulou, A. Sotiropoulos, A. Kokolaki, M. Kardara, P. Stamataki, S. Pappas, Prevalence of thyroid dysfunction among Greek type 2 diabetic patients attending an outpatient clinic. J. Clin. Med. Res. 2(2), 75–78 (2010). doi:10.4021/jocmr2010.03.281w PubMedPubMedCentral A. Papazafiropoulou, A. Sotiropoulos, A. Kokolaki, M. Kardara, P. Stamataki, S. Pappas, Prevalence of thyroid dysfunction among Greek type 2 diabetic patients attending an outpatient clinic. J. Clin. Med. Res. 2(2), 75–78 (2010). doi:10.​4021/​jocmr2010.​03.​281w PubMedPubMedCentral
16.
Zurück zum Zitat W.T. Friedewald, R.I. Levy, D.S. Fredrickson, Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin. Chem. 18(6), 499–502 (1972)PubMed W.T. Friedewald, R.I. Levy, D.S. Fredrickson, Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin. Chem. 18(6), 499–502 (1972)PubMed
17.
Zurück zum Zitat Chinese Medical Association Endocrinology Branch, Throid disease diagnosis and treatment guidelines --- Hypothyroidism (article in Chinese). J. Intern. Med. 46, 967–971 (2007) Chinese Medical Association Endocrinology Branch, Throid disease diagnosis and treatment guidelines --- Hypothyroidism (article in Chinese). J. Intern. Med. 46, 967–971 (2007)
21.
Zurück zum Zitat D. Zhang, L. Zhang, Y. Zhang, et al., Association of subclinical hypothyroidism with diabetic chronic complications in type 2 diabetic patients (article in Chinese). Chin. J. Diabetes (2014) D. Zhang, L. Zhang, Y. Zhang, et al., Association of subclinical hypothyroidism with diabetic chronic complications in type 2 diabetic patients (article in Chinese). Chin. J. Diabetes (2014)
23.
Zurück zum Zitat A. Moura Neto, M.C. Parisi, S.M. Alegre, E.J. Pavin, M.A. Tambascia, D.E. Zantut-Wittmann, Relation of thyroid hormone abnormalities with subclinical inflammatory activity in patients with type 1 and type 2 diabetes mellitus. Endocrine 51(1), 63–71 (2016). doi:10.1007/s12020-015-0651-5 CrossRefPubMed A. Moura Neto, M.C. Parisi, S.M. Alegre, E.J. Pavin, M.A. Tambascia, D.E. Zantut-Wittmann, Relation of thyroid hormone abnormalities with subclinical inflammatory activity in patients with type 1 and type 2 diabetes mellitus. Endocrine 51(1), 63–71 (2016). doi:10.​1007/​s12020-015-0651-5 CrossRefPubMed
25.
Zurück zum Zitat J. Xu, Y.H. Zhao, Y.P. Chen, X.L. Yuan, J. Wang, H. Zhu, C.M. Lu, Maternal circulating concentrations of tumor necrosis factor-alpha, leptin, and adiponectin in gestational diabetes mellitus: a systematic review and meta-analysis. Scientific World J. 2014, 926932 (2014). doi:10.1155/2014/926932 J. Xu, Y.H. Zhao, Y.P. Chen, X.L. Yuan, J. Wang, H. Zhu, C.M. Lu, Maternal circulating concentrations of tumor necrosis factor-alpha, leptin, and adiponectin in gestational diabetes mellitus: a systematic review and meta-analysis. Scientific World J. 2014, 926932 (2014). doi:10.​1155/​2014/​926932
26.
Zurück zum Zitat T.M. Ortiga-Carvalho, K.J. Oliveira, B.A. Soares, C.C. Pazos-Moura, The role of leptin in the regulation of TSH secretion in the fed state: in vivo and in vitro studies. J. Endocrinol. 174(1), 121–125 (2002)CrossRefPubMed T.M. Ortiga-Carvalho, K.J. Oliveira, B.A. Soares, C.C. Pazos-Moura, The role of leptin in the regulation of TSH secretion in the fed state: in vivo and in vitro studies. J. Endocrinol. 174(1), 121–125 (2002)CrossRefPubMed
27.
Zurück zum Zitat P. Perros, R.J. McCrimmon, G. Shaw, B.M. Frier, Frequency of thyroid dysfunction in diabetic patients: value of annual screening. Diabetic Med. 12(7), 622–627 (1995)CrossRefPubMed P. Perros, R.J. McCrimmon, G. Shaw, B.M. Frier, Frequency of thyroid dysfunction in diabetic patients: value of annual screening. Diabetic Med. 12(7), 622–627 (1995)CrossRefPubMed
28.
Zurück zum Zitat J. Kvetny, P.E. Heldgaard, E.M. Bladbjerg, J. Gram, Subclinical hypothyroidism is associated with a low-grade inflammation, increased triglyceride levels and predicts cardiovascular disease in males below 50 years. Clin. Endocrinol. 61(2), 232–238 (2004). doi:10.1111/j.1365-2265.2004.02088.x CrossRef J. Kvetny, P.E. Heldgaard, E.M. Bladbjerg, J. Gram, Subclinical hypothyroidism is associated with a low-grade inflammation, increased triglyceride levels and predicts cardiovascular disease in males below 50 years. Clin. Endocrinol. 61(2), 232–238 (2004). doi:10.​1111/​j.​1365-2265.​2004.​02088.​x CrossRef
30.
Zurück zum Zitat F. Jia, J. Tian, F. Deng, G. Yang, M. Long, W. Cheng, B. Wang, J. Wu, D. Liu, Subclinical hypothyroidism and the associations with macrovascular complications and chronic kidney disease in patients with Type 2 diabetes. Diabetic Med. 32(8), 1097–1103 (2015). doi:10.1111/dme.12724 CrossRefPubMed F. Jia, J. Tian, F. Deng, G. Yang, M. Long, W. Cheng, B. Wang, J. Wu, D. Liu, Subclinical hypothyroidism and the associations with macrovascular complications and chronic kidney disease in patients with Type 2 diabetes. Diabetic Med. 32(8), 1097–1103 (2015). doi:10.​1111/​dme.​12724 CrossRefPubMed
31.
Zurück zum Zitat M. Suher, E. Koc, N. Ata, C. Ensari, Relation of thyroid disfunction, thyroid autoantibodies, and renal function. Renal Fail. 27(6), 739–742 (2005)CrossRef M. Suher, E. Koc, N. Ata, C. Ensari, Relation of thyroid disfunction, thyroid autoantibodies, and renal function. Renal Fail. 27(6), 739–742 (2005)CrossRef
32.
Zurück zum Zitat E. Guastamacchia, V. Triggiani, A. Aglialoro, A. Aiello, L. Ianni, M. Maccario, M. Zini, C. Giorda, R. Guglielmi, C. Betterle, R. Attanasio, G. Borretta, P. Garofalo, E. Papini, R. Castello, A. Ceriello, Italian Association of Clinical Endocrinologists (AME) & Italian Association of Clinical Diabetologists (AMD) position statement: diabetes mellitus and thyroid disorders: recommendations for clinical practice. Endocrine 49(2), 339–352 (2015). doi:10.1007/s12020-014-0474-9 CrossRefPubMed E. Guastamacchia, V. Triggiani, A. Aglialoro, A. Aiello, L. Ianni, M. Maccario, M. Zini, C. Giorda, R. Guglielmi, C. Betterle, R. Attanasio, G. Borretta, P. Garofalo, E. Papini, R. Castello, A. Ceriello, Italian Association of Clinical Endocrinologists (AME) & Italian Association of Clinical Diabetologists (AMD) position statement: diabetes mellitus and thyroid disorders: recommendations for clinical practice. Endocrine 49(2), 339–352 (2015). doi:10.​1007/​s12020-014-0474-9 CrossRefPubMed
33.
Zurück zum Zitat J.G. Hollowell, N.W. Staehling, W.D. Flanders, W.H. Hannon, E.W. Gunter, C.A. Spencer, L.E. Braverman, Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J. Clin. Endocrinol. Metab. 87(2), 489–499 (2002). doi:10.1210/jcem.87.2.8182 CrossRefPubMed J.G. Hollowell, N.W. Staehling, W.D. Flanders, W.H. Hannon, E.W. Gunter, C.A. Spencer, L.E. Braverman, Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J. Clin. Endocrinol. Metab. 87(2), 489–499 (2002). doi:10.​1210/​jcem.​87.​2.​8182 CrossRefPubMed
34.
Zurück zum Zitat A.M. Michalek, M.C. Mahoney, D. Calebaugh, Hypothyroidism and diabetes mellitus in an American Indian population. J. Fam. Pract. 49(7), 638–640 (2000)PubMed A.M. Michalek, M.C. Mahoney, D. Calebaugh, Hypothyroidism and diabetes mellitus in an American Indian population. J. Fam. Pract. 49(7), 638–640 (2000)PubMed
35.
Zurück zum Zitat A. Giandalia, G.T. Russo, E.L. Romeo, A. Alibrandi, P. Villari, A.A. Mirto, G. Armentano, S. Benvenga, D. Cucinotta, Influence of high-normal serum TSH levels on major cardiovascular risk factors and Visceral Adiposity Index in euthyroid type 2 diabetic subjects. Endocrine 47(1), 152–160 (2014). doi:10.1007/s12020-013-0137-2 CrossRefPubMed A. Giandalia, G.T. Russo, E.L. Romeo, A. Alibrandi, P. Villari, A.A. Mirto, G. Armentano, S. Benvenga, D. Cucinotta, Influence of high-normal serum TSH levels on major cardiovascular risk factors and Visceral Adiposity Index in euthyroid type 2 diabetic subjects. Endocrine 47(1), 152–160 (2014). doi:10.​1007/​s12020-013-0137-2 CrossRefPubMed
36.
Zurück zum Zitat G.C. Gonzalez, I. Capel, J. Rodriguez-Espinosa, D. Mauricio, A. de Leiva, A. Perez, Thyroid autoimmunity at onset of type 1 diabetes as a predictor of thyroid dysfunction. Diabetes Care 30(6), 1611–1612 (2007). doi:10.2337/dc06-2595 CrossRefPubMed G.C. Gonzalez, I. Capel, J. Rodriguez-Espinosa, D. Mauricio, A. de Leiva, A. Perez, Thyroid autoimmunity at onset of type 1 diabetes as a predictor of thyroid dysfunction. Diabetes Care 30(6), 1611–1612 (2007). doi:10.​2337/​dc06-2595 CrossRefPubMed
39.
Zurück zum Zitat S. Furukawa, S. Yamamoto, Y. Todo, K. Maruyama, T. Miyake, T. Ueda, T. Niiya, T. Senba, M. Torisu, T. Kumagi, S. Miyauchi, T. Sakai, H. Minami, H. Miyaoka, B. Matsuura, Y. Hiasa, M. Onji, T. Tanigawa, Association between subclinical hypothyroidism and diabetic nephropathy in patients with type 2 diabetes mellitus. Endocrine J. 61(10), 1011–1018 (2014)CrossRef S. Furukawa, S. Yamamoto, Y. Todo, K. Maruyama, T. Miyake, T. Ueda, T. Niiya, T. Senba, M. Torisu, T. Kumagi, S. Miyauchi, T. Sakai, H. Minami, H. Miyaoka, B. Matsuura, Y. Hiasa, M. Onji, T. Tanigawa, Association between subclinical hypothyroidism and diabetic nephropathy in patients with type 2 diabetes mellitus. Endocrine J. 61(10), 1011–1018 (2014)CrossRef
40.
Zurück zum Zitat J. Lado-Abeal, Thyroid hormones are needed to sustain “inappropriately” normal TSH during non-thyroidal illness syndrome: a clinical observation in severely ill patients with primary hypothyroidism. Neuro Endocrinol. Lett. 36(1), 41–47 (2015)PubMed J. Lado-Abeal, Thyroid hormones are needed to sustain “inappropriately” normal TSH during non-thyroidal illness syndrome: a clinical observation in severely ill patients with primary hypothyroidism. Neuro Endocrinol. Lett. 36(1), 41–47 (2015)PubMed
41.
Zurück zum Zitat S. Khatiwada, B. Gelal, M.K. Tamang, R. Kc, S. Singh, M. Lamsal, N. Baral, Iodized salt use and salt iodine content among household salts from six districts of eastern Nepal. J. Nepal Health Res. Counc. 12(28), 191–194 (2014)PubMed S. Khatiwada, B. Gelal, M.K. Tamang, R. Kc, S. Singh, M. Lamsal, N. Baral, Iodized salt use and salt iodine content among household salts from six districts of eastern Nepal. J. Nepal Health Res. Counc. 12(28), 191–194 (2014)PubMed
Metadaten
Titel
The prevalence and determinants of hypothyroidism in hospitalized patients with type 2 diabetes mellitus
verfasst von
Fei Song
Cuiping Bao
Meiyu Deng
Hui Xu
Meijuan Fan
Stéphanie Paillard-Borg
Weili Xu
Xiuying Qi
Publikationsdatum
07.09.2016
Verlag
Springer US
Erschienen in
Endocrine / Ausgabe 1/2017
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-016-1095-2

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