Prevalence of thyroid dysfunction in older Chinese patients with type 2 diabetes-A multicenter cross-sectional observational study across China

被引：32

作者：

Zhu, Yu ^{[1
]}

Xu, Fengmei ^{[2
]}

Shen, Jie ^{[3
]}

Liu, Youshuo ^{[4
]}

Bi, Changhua ^{[5
]}

Liu, Jing ^{[6
]}

Li, Yufeng ^{[7
]}

Wang, Xueqin ^{[8
]}

Gao, Zhengnan ^{[9
]}

Liang, Linlang ^{[10
]}

Chen, Yanyan ^{[11
]}

Sun, Weiping ^{[12
]}

Guan, Qingbo ^{[13
]}

Zhang, Junqing ^{[14
]}

Luo, Zuojie ^{[15
]}

Guo, Lixin ^{[16
]}

Cai, Xiaopin ^{[17
]}

Li, Ling ^{[18
]}

Xiu, Lingling ^{[19
]}

Yan, Li ^{[20
]}

Li, Chunlin ^{[21
]}

Shi, Xiaoyun ^{[22
]}

Zhu, Mei ^{[23
]}

Kuang, Jian ^{[24
]}

Li, Guangwei ^{[11
]}

Ji, Linong ^{[1
]}

机构：

[1] Peking Univ, Peoples Hosp, Beijing, Peoples R China

[2] Hebi Coal Ind Grp Co Ltd, Gen Hosp, Hebi, Peoples R China

[3] Southern Med Univ, Affiliated Hosp 3, Guangzhou, Guangdong, Peoples R China

[4] Cent S Univ, Xiangya Hosp 2, Changsha, Hunan, Peoples R China

[5] CNPC Cent Hosp, Langfang, Hebei, Peoples R China

[6] Gansu Prov Hosp, Lanzhou, Gansu, Peoples R China

[7] Beijing Pinggu Hosp, Beijing, Peoples R China

[8] Univ Chinese Acad Sci, Beijing Huairou Hosp, Beijing, Peoples R China

[9] Dalian Med Univ, Dalian Municipal Cent Hosp, Dalian, Peoples R China

[10] Gen Hosp Shenyang Mil Reg, Shenyang, Liaoning, Peoples R China

[11] Chinese Acad Med Sci, Fuwai Hosp, Beijing, Peoples R China

[12] First Peoples Hosp Xiangtan City, Xiangtan, Peoples R China

[13] Shandong Prov Hosp, Jinan, Shandong, Peoples R China

[14] Peking Univ, Hosp 1, Beijing, Peoples R China

[15] Guangxi Med Univ, Affiliated Hosp 1, Guangxi, Peoples R China

[16] Beijing Hosp, Beijing, Peoples R China

[17] China Japan Friendship Hosp, Beijing, Peoples R China

[18] China Med Univ, Shengjing Hosp, Shenyang, Liaoning, Peoples R China

[19] Sun Yat Sen Univ, Affiliated Hosp 1, Guangzhou, Guangdong, Peoples R China

[20] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Guangzhou, Guangdong, Peoples R China

[21] Peoples Liberat Army 301 Hosp, Gen Hosp, Beijing, Peoples R China

[22] Chinese Peoples Armed Police Forces, Gen Hosp, Beijing, Peoples R China

[23] Tianjin Med Univ, Gen Hosp, Tianjin, Peoples R China

[24] Guangdong Gen Hosp, Guangzhou, Guangdong, Peoples R China

来源：

PLOS ONE | 2019年 / 14卷 / 05期

关键词：

ASSOCIATION; HYPOTHYROIDISM; RISK;

D O I：

10.1371/journal.pone.0216151

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Type 2 diabetes [T2D] and thyroid dysfunction [TD] often co-occur, have overlapping pathologies, and their risk increases with age. Since 1995, universal salt iodization has been implemented in China to prevent disorders caused by iodine deficiency. However, after two decades of implementation of universal salt iodization, the prevalence of TD in elderly Chinese patients with T2D is not well described and may have been underestimated. We conducted a questionnaire-based survey across 24 endocrinology centers in China between December 2015 and July 2016. Demographic and clinical data from 1677 patients with T2D were obtained and analyzed to examine the prevalence of TD along with T2D in these patients. We assessed TD prevalence according to the four TD subtypes [subclinical hypothyroidism, clinical hypothyroidism, subclinical hyperthyroidism, and clinical hyperthyroidism], TD history, gender, and age. The diagnosis rates were calculated for TD and also for the TD subtype. The number of patients reaching treatment goals for T2D [hemoglobin A1c < 7%] and TD [normal free thyroxine and thyroid-stimulating hormone [TSH]] and the incidences of complications and comorbidities were recorded. Among the enrolled patients with T2D [N = 1677], TD was diagnosed in 23.79% [399/1677] out of which 61% (245/399) were previously diagnosed and 38.59% (154/399) were newly diagnosed cases. Subclinical hypothyroidism, clinical hypothyroidism, subclinical hyperthyroidism, and clinical hyperthyroidism were reported in 4.89%, 9.3%, 1.13%, and 3.16% of the total population, respectively. Among patients previously diagnosed with TD, the incidence in women [166/795; 20.88%] was higher than in men [79/882; 8.96%]. The treatment goals for TD and T2D were attained in 39.6% [97/245] and 34.41% [577/1677] of the cases, respectively. Diabetic complications and comorbidities were reported in 99.7% of patients, with peripheral neuropathy being the most common [43.46%] followed by cataract [24.73%]. We had found that the incidences of dyslipidemia, elevated LDL levels, and osteoporosis were significantly higher in patients with TD than those without TD. TD is underdiagnosed in elderly Chinese patients with T2D.

引用

页数：14

共 46 条

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