Association between subclinical hypothyroidism and severe diabetic retinopathy in Korean patients with type 2 diabetes

被引:51
作者
Kim, Bo-Yeon [1 ]
Kim, Chul-Hee [1 ]
Jung, Chan-Hee [1 ]
Mok, Ji-Oh [1 ]
Suh, Kyo-Il [1 ]
Kang, Sung-Koo [1 ]
机构
[1] Soonchunhyang Univ, Coll Med, Bucheon Hosp, Dept Internal Med,Div Endocrinol & Metab, Puchon 420767, South Korea
关键词
Subclinical hypothyroidism; Type 2 diabetes mellitus; Microvascular complications; Diabetic retinopathy; ISCHEMIC-HEART-DISEASE; INSULIN-RESISTANCE; THYROID-DYSFUNCTION; MACULAR EDEMA; RISK-FACTORS; HORMONES; NEPHROPATHY; THYROTROPIN; MELLITUS;
D O I
10.1507/endocrj.EJ11-0199
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The association between subclinical hypothyroidism (SCH) and microvascular complications of type 2 diabetes is unclear. We examined whether SCH is associated with diabetic retinopathy or nephropathy in Korean patients with type 2 diabetes. Data from 489 patients who visited the diabetes clinic at a university hospital between 2001 and 2007 were analyzed retrospectively. Participants were evaluated for glycemic control, thyroid function, and diabetic retinopathy and nephropathy. Diabetic retinopathy was classified into five grades. Diabetic nephropathy was assessed by the presence of albuminuria. Patients in the SCH group had a higher proportion of women, older age, longer duration of diabetes, higher systolic and diastolic blood pressure, and higher insulin resistance index compared with the euthyroid group. No significant difference in family history of diabetes or body mass index was found between groups. The prevalence of severe diabetic retinopathy (severe nonproliferative diabetic retinopathy or proliferative diabetic retinopathy) was significantly higher in the SCH group than the euthyroid group (32.8% vs. 19.6%, P = 0.036), whereas no between-group difference was found in the prevalence of diabetic nephropathy. After adjustment for potential confounding factors (HbA1c, BMI, duration of diabetes, diabetic nephropathy, and hypertension) by multivariate logistic regression analysis, SCH remained significantly associated with severe diabetic retinopathy (odds ratio 2.086(95% CI, 1.010-4.307), P = 0.047). These results suggest that SCH was independently associated with severe diabetic retinopathy in patients with type 2 diabetes. Further prospective studies are required to confirm the association between SCH and diabetic retinopathy.
引用
收藏
页码:1065 / 1070
页数:6
相关论文
共 30 条
[1]   LDL/HDL-CHANGES IN SUBCLINICAL HYPOTHYROIDISM - POSSIBLE RISK-FACTORS FOR CORONARY HEART-DISEASE [J].
ALTHAUS, BU ;
STAUB, JJ ;
RYFFDELECHE, A ;
OBERHANSLI, A ;
STAHELIN, HB .
CLINICAL ENDOCRINOLOGY, 1988, 28 (02) :157-163
[2]  
Chadarevian R, 1998, THROMB HAEMOSTASIS, V79, P99
[3]   Subclinical hypothyroidism is a risk factor for nephropathy and cardiovascular diseases in Type 2 diabetic patients [J].
Chen, H. -S. ;
Wu, T. -E. J. ;
Jap, T. -S. ;
Lu, R. -A. ;
Wang, M. -L. ;
Chen, R. -L. ;
Lin, H. -D. .
DIABETIC MEDICINE, 2007, 24 (12) :1336-1344
[4]   Evaluation of endothelial function in subclinical hypothyroidism and subclinical hyperthyroidism [J].
Cikim, AS ;
Oflaz, H ;
Ozbey, N ;
Cikim, K ;
Umman, S ;
Meric, M ;
Sencer, E ;
Molvalilar, S .
THYROID, 2004, 14 (08) :605-609
[5]   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].
Díez, JJ ;
Iglesias, P .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2004, 89 (10) :4890-4897
[6]   Different patterns of insulin resistance in relatives of type 1 diabetic patients with retinopathy or nephropathy [J].
Hadjadj, S ;
Péan, F ;
Péan, F ;
Gallois, Y ;
Passa, P ;
Aubert, R ;
Weekers, L ;
Rigalleau, V ;
Bauduceau, B ;
Bekfierraz, A ;
Roussel, R ;
Dussol, B ;
Rodier, M ;
Marechaud, R ;
Lefebvre, PJ ;
Marre, M .
DIABETES CARE, 2004, 27 (11) :2661-2668
[7]   Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: The Rotterdam study [J].
Hak, AE ;
Pols, HAP ;
Visser, TJ ;
Drexhage, HA ;
Hofman, A ;
Witteman, JCM .
ANNALS OF INTERNAL MEDICINE, 2000, 132 (04) :270-+
[8]   Risk for ischemic heart disease and all-cause mortality in subclinical hypothyroidism [J].
Imaizumi, M ;
Akahoshi, M ;
Ichimaru, S ;
Nakashima, E ;
Hida, A ;
Soda, M ;
Usa, T ;
Ashizawa, K ;
Yokoyama, N ;
Maeda, R ;
Nagataki, S ;
Eguchi, K .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2004, 89 (07) :3365-3370
[9]  
ISHIKAWA T, 1989, MOL PHARMACOL, V35, P760
[10]   Thyroid dysfunction in patients with diabetes: clinical implications and screening strategies [J].
Kadiyala, R. ;
Peter, R. ;
Okosieme, O. E. .
INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, 2010, 64 (08) :1130-1139