TYPE 2 DIABETES MELLITUS AND HYPOTHYROIDISM: LABORATORY DATA
DOI:
https://doi.org/10.11603/mcch.2410-681X.2021.i3.12448Keywords:
type 2 diabetes mellitus, hypothyroidism, laboratory dataAbstract
Introduction. Hypothyroidism is more common in patients with type 2 diabetes than in the general population. These are the two most common endocrine disorders in the world. Comorbidity of type 2 diabetes and hypothyroidism will worsen macro-vascular complications, quality of life and mortality. More and more scientists recommend routine determination of thyroid hormone levels in patients with type 2 diabetes, which will help better control these two conditions.
The aim of the study – to evaluate laboratory parameters in patients with combined course of type 2 diabetes mellitus and hypothyroidism and to identify possible markers of their comorbid course.
Research Methods. A retrospective study of medical records of 538 patients with type 2 diabetes who were treated at the Endocrine Department of Ternopil University Hospital in 2019. Two experimental groups were formed: group 1 (501 patients with type 2 diabetes mellitus (T2DM)) and group 2 (37 patients with comorbid T2DM and hypothyroidism). Laboratory data were evaluated (results of general blood analysis, lipidograms, thyroid hormones, biochemical markers). Statistical analysis was performed by calculating the median (Me), lower (Lq) and upper (Uq) quartiles, Mann-Whitney U-test.
Results and Discussion. The study of general blood tests revealed probably lower Hb and RBC in group 2 (p=<0.001 and p=0.043), the level of ESR was 15.4 % higher than in group 1 (p=0.045). HbA1c values were 10.0 % higher in group 2 (p=0.035) compared with group 1. Evaluating the lipid profile revealed significantly differences in HDL-C, RC, non-HDL-C and TG between experimental groups (p=0.01, p=0.004, p=0.008, p=0.047).
Conclusions. Patients with comorbid type 2 diabetes mellitus and hypothyroidism have significantly lower values of hemoglobin and erythrocytes, significantly higher levels of ESR, HbA1c, and progressing dyslipidemia due to HDL-C, RC, non-HDL-C and TG compered to patients with type 2 diabetes mellitus only.
References
Cho, N.H., Shaw, J.E., Karuranga, S., Huang, Y., da Rocha Fernandes, J.D., Ohlrogge, A.W., & Malanda, B. (2018). IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res. Clin. Pract., 138, 271-281. DOI:10.1016/j.diabres.2018.02.023
Mahdavi, M., Amouzegar, A., Mehran, L., Madreseh, E., Tohidi, M., & Azizi, F. (2021). Investigating the prevalence of primary thyroid dysfunction in obese and overweight individuals: Tehran thyroid study. BMC Endocr. Disord., 21 (1), 89. DOI:10.1186/s12902-021-00743-4
Ogbonna, S.U., & Ezeani, I.U. (2019). Risk factors of thyroid dysfunction in patients with type 2 diabetes mellitus. Front Endocrinol. (Lausanne), 10, 440. DOI:10.3389/fendo.2019.00440
Diab, N., Daya, N.R., Juraschek, S.P., Martin, S.S., McEvoy, J.W., Schultheiss, U.T., . . . Selvin, E. (2019). Prevalence and risk factors of thyroid dysfunction in older adults in the community. Sci. Rep., 9 (1), 13156. DOI:10.1038/s41598-019-49540-z
Elmenshawi, I.M. (2017). Prevalence of thyroid dysfunction in diabetic patients. Journal of Diabetes, Metabolic Disorders & Control, 4 (2). DOI:10.15406/jdmdc.2017.04.00106
Jali, M.V., Kambar, S., Jali, S.M., Pawar, N., & Nalawade, P. (2017). Prevalence of thyroid dysfunction among type 2 diabetes mellitus patients. Diabetes Metab. Syndr., 11 (1), S105-S108. DOI:10.1016/j.dsx.2016.12.017
Elgazar, E.H., Esheba, N.E., Shalaby, S.A., & Mohamed, W.F. (2019). Thyroid dysfunction prevalence and relation to glycemic control in patients with type 2 diabetes mellitus. Diabetes Metab. Syndr., 13 (4), 2513-2517. DOI:10.1016/j.dsx.2019.07.020
Han, C., He, X., Xia, X., Li, Y., Shi, X., Shan, Z., & Teng, W. (2015). Subclinical hypothyroidism and type 2 diabetes: A systematic review and meta-analysis. PLoS One, 10 (8), e0135233. DOI:10.1371/journal.pone.0135233
Subekti, I., Pramono, L.A., Dewiasty, E., & Harbuwono, D.S. (2017). Thyroid dysfunction in type 2 diabetes mellitus patients. Acta Med. Indones, 49 (4), 314-323.
Du, W., Wang, F., Zhao, M., Zhang, H., Zhang, X., Zhao, J., & Gao, L. (2019). Prevalence of thyroid disorders and associated risk factors with various glycemic status in North China. Biotechnology & Biotechnological Equipment, 33 (1), 1244-1250. DOI:10.1080/13102818.2019.1656106
Vanderpump, M.P.J. (2018). Epidemiology of thyroid disease. In Encyclopedia of Endocrine Diseases (pp. 486-495).
Al-Geffari, M., Ahmad, N.A., Al-Sharqawi, A.H., Youssef, A.M., Alnaqeb, D., & Al-Rubeaan, K. (2013). Risk factors for thyroid dysfunction among type 2 diabetic patients in a highly diabetes mellitus prevalent society. Int. J. Endocrinol., 2013, 417920. DOI:10.1155/2013/417920
Talwalkar, P., Deshmukh, V., & Bhole, M. (2019). Prevalence of hypothyroidism in patients with type 2 diabetes mellitus and hypertension in India: a cross-sectional observational study. Diabetes Metab. Syndr. Obes., 12, 369-376. DOI:10.2147/DMSO.S181470
Barmpari, M.E., Kokkorou, M., Micheli, A., Alexiou, I., Spanou, E., Noutsou, M., & Thanopoulou, A. (2017). Thyroid dysfunction among Greek patients with type 1 and type 2 diabetes mellitus as a disregarded comorbidity. J. Diabetes Res., 2017, 6505814. doi:10.1155/2017/6505814
Qi, Q., Zhang, Q.M., Li, C.J., Dong, R.N., Li, J.J., Shi, J.Y., . . . Zhang, J.Y. (2017). Association of thyroid-stimulating hormone levels with microvascular complications in type 2 diabetes patients. Med. Sci. Monit., 23, 2715-2720. DOI:10.12659/msm.902006
Ahmed, A.A., Mohamed, S., Elmadi, S.A., Abdorabo, A.A., Ismail, I.M., & Ismail, A.M. (2017). Assessment of thyroid dysfunctions in type 2 diabetes mellitus patients in Surman, Western-Libya. International Journal of Clinical and Experimental Medical Sciences, 3 (1), 1-4. DOI:10.11648/j.ijcems.20170301.11
American Diabetes, A. (2019). 10. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes-2019. Diabetes Care, 42 (Suppl. 1), S103-S123. DOI:10.2337/dc19-S010
Okosieme, O., Gilbert, J., Abraham, P., Boelaert, K., Dayan, C., Gurnell, M., . . . Vanderpump, M. (2016). Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee. Clin. Endocrinol. (Oxf), 84 (6), 799-808. DOI:10.1111/cen.12824
Nair, A., Jayakumari, C., Jabbar, P K., Jayakumar, R.V., Raizada, N., Gopi, A., . . . Seena, T.P. (2018). Prevalence and associations of hypothyroidism in Indian patients with type 2 diabetes mellitus. J. Thyroid Res., 2018, 5386129. doi:10.1155/2018/5386129
Khassawneh, A.H., Al-Mistarehi, A.H., Zein Alaabdin, A.M., Khasawneh, L., AlQuran, T.M., Kheirallah, K.A., . . . Obeidat, N. (2020). Prevalence and predictors of thyroid dysfunction among type 2 diabetic patients: A case-control study. Int. J. Gen. Med., 13, 803-816. DOI:10.2147/IJGM.S273900
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Medical and Clinical Chemistry
This work is licensed under a Creative Commons Attribution 4.0 International License.