Association between subclinical hypothyroidism and diabetic nephropathy in patients with type 2 diabetes mellitus

Shinya Furukawa; Shin Yamamoto; Yasuhiko Todo; Kotatsu Maruyama; Teruki Miyake; Teruhisa Ueda; Tetsuji Niiya; Takatoshi Senba; Masamoto Torisu; Teru Kumagi; Syozo Miyauchi; Takenori Sakai; Hisaka Minami; Hiroaki Miyaoka; Bunzo Matsuura; Yoichi Hiasa; Morikazu Onji; Takeshi Tanigawa

doi:10.1507/endocrj.EJ14-0206

ORIGINALS

Association between subclinical hypothyroidism and diabetic nephropathy in patients with type 2 diabetes mellitus

Shinya Furukawa, Shin Yamamoto, Yasuhiko Todo, Kotatsu Maruyama, Teruki Miyake, Teruhisa Ueda, Tetsuji Niiya, Takatoshi Senba, Masamoto Torisu, Teru Kumagi, Syozo Miyauchi, Takenori Sakai, Hisaka Minami, Hiroaki Miyaoka, Bunzo Matsuura, Yoichi Hiasa, Morikazu Onji, Takeshi Tanigawa

Author information

Shinya Furukawa
Department of Public Health, Ehime University Graduate School of Medicine, Toon 791-0295, Japan
Shin Yamamoto
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon 791-0295, Japan
Yasuhiko Todo
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon 791-0295, Japan
Kotatsu Maruyama
Department of Basic Research and Education, Ehime University Graduate School of Medicine, Toon 791-0295, Japan
Teruki Miyake
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon 791-0295, Japan
Teruhisa Ueda
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon 791-0295, Japan
Tetsuji Niiya
Department of Internal Medicine, Matsuyama City Hospital, Matsuyama 790-0067, Japan
Takatoshi Senba
Department of Internal Medicine, Matsuyama City Hospital, Matsuyama 790-0067, Japan
Masamoto Torisu
Department of Internal Medicine, Saiseikai Saijo Hospital, Saijo 793-0027, Japan
Teru Kumagi
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon 791-0295, Japan
Syozo Miyauchi
Department of Internal Medicine, Uwajima City Hospital, Uwajima 798-8510, Japan
Takenori Sakai
Department of Internal Medicine, Yawatahama General City Hospital, Yawatahama 796-8502, Japan
Hisaka Minami
Department of Internal Medicine, Ehime Niihama Hospital, Niihama 792-0042, Japan
Hiroaki Miyaoka
Department of Internal Medicine, Saiseikai Matsuyama Hospital, Matsuyama 791-8026, Japan
Bunzo Matsuura
Department of Lifestyle-related Medicine and Endocrinology, Ehime University Graduate School of Medicine, Toon 791-0295, Japan
Yoichi Hiasa
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon 791-0295, Japan
Morikazu Onji
Department of Internal Medicine, Saiseikai Imabari Hospital, Imabari 799-1592, Japan
Takeshi Tanigawa
Department of Public Health, Ehime University Graduate School of Medicine, Toon 791-0295, Japan
Department of Public Health, Juntendo University Graduate School Medicine, Tokyo 113-8421, Japan

Keywords: Dyslipidemia, Kidney, Metabolic disease, Microvascular disease, Thyroid-stimulating hormone

JOURNAL FREE ACCESS

2014 Volume 61 Issue 10 Pages 1011-1018

DOI https://doi.org/10.1507/endocrj.EJ14-0206

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Abstract

Subclinical hypothyroidism (SCH) has been associated with type 2 diabetes mellitus. However, it is unknown whether common complications of type 2 diabetes, such as diabetic nephropathy, are also present with SCH. Here, we investigated the association between SCH and diabetic nephropathy among Japanese patients with type 2 diabetes mellitus. In this multicenter cross-sectional study, we recruited 414 such patients who had no previous history of thyroid disease. Serum thyroid hormone levels and the urinary albumin:creatinine ratio were measured. SCH was defined as an elevated thyroid-stimulating hormone (TSH) level (>4.0 mIU/L), and diabetic nephropathy was defined as urinary albumin/creatinine ratio ≥300 mg/g. The prevalence of SCH was 8.7% (n = 36) among patients with type 2 diabetes mellitus. The SCH group had a higher prevalence of dyslipidemia (p = 0.008) and diabetic nephropathy (p = 0.014) than the euthyroid group. Multivariate analysis identified significant positive associations between diabetic nephropathy and SCH (odds ratio [OR], 3.51; 95% confidence interval [CI], 1.10−10.0; p = 0.034), hypertension (OR, 4.56; 95% CI, 1.69−14.7; p = 0.001), and smoking (OR, 3.02; 95% CI, 1.14−7.91; p = 0.026). SCH may be independently associated with diabetic nephropathy in Japanese patients with type 2 diabetes mellitus.

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