Endocrine Abstracts

Background and aims: Diabetes type 2 (DT2) is a chronic condition that damages the whole metabolism. It has a growing incidence and is recognized as epidemic of 21st century. One of the most common complications of DT2 is diabetic nephropathy (DN). It is caused by persistent hyperglycemia and kidney damage. Microalbuminuria is one of the most important hallmarks of DN. Besides, it increases a risk of cardiovascular and neurological complications. Microalbuminuria is defined as albumin/creatinin ratio (ACR) 30-300 mg/g or daily albumin excretion 30-300 mg/24 h. DT2 is often accompanied by thyroid dysfunction. According to literature reviews, microalbuminuria is associated with thyroid function disorders. Our research aimed to study structure and function of thyroid gland in patients with DT2 and microalbuminuria.

Materials and methods: our study included 87 individuals (mean age – 57.1±0.86 years; mean ACR – 139±5.5 mg/g) with DT2 and no history of thyroid gland disorders. All participants had HbA1c level below 8.0% and did not change glucose-lowering agents during the study. Thyrotropin-stimulating hormone (TSH), free T4 (fT4), free T3 (fT3), thyroid-peroxidase antibodies (anti-TPO) levels were obtained as well as thyroid gland ultrasound.

Results: TSH (mean level 2.75±0,34) positively correlated with ACR (r=0.09, P<0.05). FT4 (14.32±1.09) and fT3 (2.37±0.18) levels negatively correlated with ACR (r= -0.22, P<0.05 and r= -0.17, P<0.05 respectively), whereas Anti-TPO level (57.26±6.84) positively correlated with ACR (r=0.09, P<0.05). Total thyroid gland volume (17.72±1.39 ml) positively correlated with ACR (r=0.05, P<0.05).

Conclusion: our study demonstrates a strong association between thyroid and renal function. Patients with DN more often have hypothyroidism, positive anti-TPO, and greater total thyroid volume. Effective treatment of hypothyroidism in these patients can improve clinical outcomes of DT2 and microalbuminuria.