Endocrine Abstracts

Background: Subclinical hypothyroidism is a common thyroid disorder. Although there is a recognized association between thyroid disease and diabetes mellitus, there is no definite answer as to whether screening for subclinical hypothyroidism is necessary in patients with type 2 diabetes.

Objective: To evaluate the prevalence of subclinical hypothyroidism in women with type 2 diabetes in Egypt.

Patients and methods: women with type 2 diabetes (54.3±9.3 years) and 100 women without diabetes (49.2±5.3 years) participated. Those with type 1 diabetes, thyroid disorders, chronic illness or receiving drugs that affect thyroid function were excluded. They were assessed for FBS, HbA1c, lipid profile, ultrasensitive CRP, urine albumin:creatinine ratio and thyroid parameters as TSH, FT₄, anti-thyroid peroxidase antibodies (TPO), and thyroid volume by neck ultrasound.

Results: The prevalence of subclinical hypothyroidism was 9% in diabetic patients and 3% in control subjects with no significant statistical difference between the two groups (P=0.09). FT₄ was lower in diabetic group than controls with P<0.001. TSH was higher in diabetics than control with P<0.01. The prevalence of TPO was similar in both groups (P=0.3) as well as the thyroid volume (P=0.8). Across all participants, positivity for TPO was significantly higher in patients with subclinical hypothyroidism than in euthyroid subjects. usCRP was higher in diabetic patients (P<0.001), and was positively correlated with parameters of the metabolic profile rather than the thyroid profile parameters. In our study, thyroid parameters among different stages of diabetic nephropathy showed no significant difference, but patients with macroalbuminuria have the lowest FT₄ values and highest TSH values.

Conclusion: The statistical insignificant difference in the prevalence of subclinical hypothyroidism in women with type 2 diabetes and women without diabetes suggests that routine screening of thyroid function in patients with type 2 diabetes is unwarranted. However, further mega studies are recommended.