scholarly journals Thyroid Function in Patients with Type 2 Diabetes Mellitus and Diabetic Nephropathy: A Single Center Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Wei Zhao ◽  
Xinyu Li ◽  
Xuhan Liu ◽  
Lu Lu ◽  
Zhengnan Gao

Background. Diabetes mellitus is a common metabolic disease and the prevalence is increasing rapidly. Thyroid disorders including subclinical hypothyroidism (SCH) and low triiodothyronine (T3) syndrome are frequently observed in diabetic patients. We conducted a study to explore thyroid function in patients with type 2 diabetes mellitus (T2DM) and diabetic nephropathy (DN). Methods. We included 103 healthy volunteers, 100 T2DM patients without DN, and 139 with DN. Physical examinations including body mass index and blood pressure and laboratory measurements including renal function, thyroid function, and glycosylated hemoglobin were conducted. Results. Patients with DN had higher thyroid stimulating hormone (TSH) levels and lower free T3 (FT3) levels than those without DN (p < 0.01). The prevalence of SCH and low FT3 syndrome in patients with DN was 10.8% and 20.9%, respectively, higher than that of controls and patients without DN (p < 0.05). Through Pearson correlation or Spearman rank correlation analysis, in patients with DN, there were positive correlations in TSH with serum creatinine (r = 0.363, p = 0.013) and urinary albumin-to-creatinine ratio (r = 0.337, p = 0.004), and in FT3 with estimated glomerular filtration rate (eGFR) with statistical significance (r = 0.560, p < 0.001). Conclusions. High level of TSH and low level of FT3 were observed in T2DM patients with DN. Routine monitoring of thyroid function in patients with DN is necessary, and management of thyroid dysfunction may be a potential therapeutic strategy of DN.

2020 ◽  
Author(s):  
Xiaomeng Sun ◽  
Jia Liu ◽  
Guang Wang

Abstract Background: This study was to research the efficacy of fenofibrate in the treatment of microalbuminuria in the patients with type 2 diabetes mellitus (T2DM) and hypertriglyceridemia. Methods: Type 2 diabetic patients (56) with microalbuminuria and hypertriglyceridemia aged 30 to 75 were randomly divided into the fenofibrate treatment group(n=28) and the control group (n=28) for 180 days. Urinary microalbumin /creatinine ratio (UACR) and other metabolic parameters were compared at baseline, during treatment and after treatment. Results: After 180 days, the reduction of levels of fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c) in two groups were no differences. In treatment group, uric acid (UA) (296.42 ± 56.41 vs 372.46 ± 72.78), triglyceride (TG) [1.51(1.17, 2.06) vs 3.04(2.21, 3.29)], and UACR [36.45 (15.78,102.41) vs 129.00 (53.00, 226.25)] were significantly decreased compared with the baseline. The high-density lipoprotein cholesterol (HDL-C) levels were significantly increased (1.22 ± 0.26 vs 1.09 ± 0.24) compared with the baseline. The decrease in UACR [-44.05(-179.47, -12.16) vs -8.15(-59.69, 41.94)]in treatment group was significantly higher compared with the control group. The decrease in UACR was positively associated with the decreases in TG ( r = 0.447, P = 0.042) and UA ( r = 0.478, P = 0.024) after fenofibrate treatment. Conclusion: In the patients with hypertriglyceridemia and type 2 diabetes mellitus, fenofibrate can improve microalbuminuria and do not increase the deterioration of glomerular filtration rate


2021 ◽  
Vol 10 (25) ◽  
pp. 1866-1870
Author(s):  
Bhuneshwar Yadav ◽  
Shashidhar K.N ◽  
Raveesha A ◽  
Muninarayana C.

BACKGROUND Increased levels of urinary biomarkers can be detected in type 2 diabetic patients before the onset of significant albuminuria and may be used as an early marker of renal injury in diabetic nephropathy (DN) which would play a significant role for the effective management and treatment approaches in diabetic care. We wanted to evaluate cystatin C and microalbumin as effective early biomarkers in assessing nephropathy in patients with type 2 diabetes mellitus in this study. METHODS A cross-sectional study was conducted among 180 subjects grouped into healthy controls, clinically proven T2DM without nephropathy and type 2 DM with nephropathy comprising 60 participants in each group. Fasting and postprandial blood samples and urine samples were collected and analysed by standard methods. eGFR was calculated using CKD-EPI 2012 equation. IBM - SPSS version 20 was used for statistical analysis. RESULTS Diabetic nephropathy patients had significantly elevated serum cystatin C and microalbumin (2.43 ± 0.59, 700.5 ± 591.8 mg / L, respectively), compared to T2DM (0.98 ± 0.26, 63.7 ± 102.9 mg / L, respectively), and the control study subjects (0.81 ± 0.16, 11.15 ± 8.9 mg / L, respectively). Serum cystatin C showed AUC of 0.994 (95 % CI, 0.986 - 1.00) whereas microalbumin showed 0.944 (95 % CI, 0.907 - 0.981). Serum cystatin C showed a sensitivity of 96.7 % and a specificity of 91.7 % at a cutoff point of 1.34 mg / L whereas at a cut-off point of 138.5 mg / L for microalbumin, the sensitivity and specificity were 90 % and 83.3 % respectively. CONCLUSIONS Serum cystatin C and microalbumin both could be considered as markers for early detection of nephropathy in T2DM patients. The more prominent rise in serum cystatin C values provide an earlier diagnosis of diabetic nephropathy among T2DM patients. KEY WORDS Biomarker, Type 2 Diabetes Mellitus, Cystatin C, Diabetic Nephropathy, Microalbumin


2021 ◽  
Vol 12 ◽  
Author(s):  
Mengni Li ◽  
Rongping Fan ◽  
Xuemin Peng ◽  
Jiaojiao Huang ◽  
Huajie Zou ◽  
...  

BackgroundPrevious studies showed altered angiopoietin-like protein-8 (ANGPTL-8) and resistin circulating levels in type 2 diabetes mellitus (T2DM). Whether or not the alteration in ANGPTL-8 and resistin level can be a predictive maker for increased diabetic nephropathy risk remains unclear.AimTo Investigate the possible association of ANGPTL-8 and resistin with DN, and whether this association is affected by NAFLD status.MethodsA total of 278 T2DM patients were enrolled. Serum levels of ANGPTL8, resistin, BMI, blood pressure, duration of diabetes, glycosylated hemoglobin (HbA1c), fasting blood glucose (FPG), hypersensitive C-reactive protein (hs-CRP), lipid profile, liver, and kidney function tests were assessed. The relationship between DN with ANGPTL8 and resistin was analyzed in the unadjusted and multiple-adjusted regression models.ResultsSerum levels of ANGPTL8 and resistin were significantly higher in DN compared with T2DM subjects without DN (respectively; P &lt;0.001), especially in non-NAFLD populations. ANGPTL8 and resistin showed positive correlation with hs-CRP (respectively; P&lt;0.01), and negative correlation with estimated GFR (eGFR) (respectively; P=&lt;0.001) but no significant correlation to HOMA-IR(respectively; P&gt;0.05). Analysis showed ANGPTL8 levels were positively associated with resistin but only in T2DM patients with DN(r=0.1867; P&lt;0.05), and this significant correlation disappeared in T2DM patients without DN. After adjusting for confounding factors, both ANGPTL8(OR=2.095, 95%CI 1.253-3.502 P=0.005) and resistin (OR=2.499, 95%CI 1.484-4.208 P=0.001) were risk factors for DN. Data in non-NAFLD population increased the relationship between ANGPTL8 (OR=2.713, 95% CI 1.494-4.926 P=0.001), resistin (OR=4.248, 95% CI 2.260-7.987 P&lt;0.001)and DN. The area under the curve (AUC) on receiver operating characteristic (ROC) analysis of the combination of ANGPTL8 and resistin was 0.703, and the specificity was 70.4%. These data were also increased in non-NAFLD population, as the AUC (95%CI) was 0.756, and the specificity was 91.2%.ConclusionThis study highlights a close association between ANGPTL8, resistin and DN, especially in non-NAFLD populations. These results suggest that ANGPTL-8 and resistin may be risk predictors of DN.


2021 ◽  
pp. 6-8
Author(s):  
Yash Salil Patel

Microvascular complications of Type 2 Diabetes Mellitus (T2DM), (retinopathy and nephropathy) have a similar etiopathogenetic mechanism besides genetic predisposition. Even though these two complications frequently co-exist, their frequency varies. The association of these two signicant complications and their coexistence needs a relook. To study prevalence of retinopathy and nephropathy in Type 2 diabetes mel Aim: litus. Comparison of diabetic retinopathy and nephropathy in Type 2 diabetes mellitus and its correlation of diabetic retinopathy and nephropathy with duration of illness and various risk factors that affects development, progression and severity of diabetic retinopathy and nephropathy. 100 diabetic patients were taken up for study for a period of one year meeti Methodology: ng the criteria for the present study. Detailed history was taken from patient and meticulous examination was done of all patients with special emphasis on renal and ophthalmic symptoms. Clinical data and investigation prole was tabulated. Statistical analysis was done. Among 100 patients, 22 had diabetic retinopathy. Among patients with diab Results & Conclusion: etic retinopathy, 68.18% patients had positive family history. Among 100 patients, 32 had diabetic nephropathy, mean FBS was 207 mg%, PPBS was 317.8 mg% and mean HbA was 9.2%. Among patients with diabetic retinopathy, mean FBS was 211 mg%, PPBS was 324.9 1c mg%, HbA was 9.5%. From this study it is found that diabetic nephropathy starts earlier than retinopathy. In this study 1c hypertension was found to accelerate progression into nephropathy and retinopathy.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Elbis Ahbap Dal ◽  
Taner Basturk ◽  
Tamer Sakaci ◽  
Nuri Baris Hasbal ◽  
Mustafa Sevinç ◽  
...  

Abstract Background and Aims The aim of the study is to evaluate kidney biopsy findings other than renal diabetic changes in patients with type 2 diabetes mellitus. Method Diabetic patients with kidney biopsy between January 2003 and January 2020 were enrolled to the study. Kidney biopsy was performed to patients with suspicion of kidney disease other than diabetic nephropathy. The suspicious cases were patients without diabetic retinopathy, diabetes mellitus history less than 5 years, creatinine increase faster than expected course and hematuria. Demographic features, biopsy finding were all noted. Results Totally, 135 patients’ data were evaluated in which 54.1% was male. Demographic characteristics of the patients and laboratory data are given in Table 1. Mean age was 55.4±11 years and mean diabetes duration was 6.9±6.3 years. Mean duration of diabetes was 5.3±5.5 years in patients with nondiabetic nephropathy whereas it was 10.2±6.4 and 11.2±7.6 years in patients with diabetic and/or nondiabetic pathologies respectively (p&lt;0.05). Serum creatinine and proteinuria level were lower, and hemoglobin levels were higher in patients with nondiabetic nephropathy (p &lt;0.05).C3 was low in 3.7% of patients. ANA and ANCA positivity were seen in 8.1% and 3.7% of the patients, respectively. Patients without diabetic retinopathy was 81.7% of the total cohort. Biopsy indications were renal insufficiency (8.9%), nephrotic syndrome (24.4%), non-nephrotic proteinuria (16.4%), renal insufficiency with nephrotic range proteinuria (25.9%), renal insufficiency with non-nephrotic proteinuria (24.4%). Mean glomeruli number was 19.3±11.1. Ten patients had macroscopic hematuria in which all resolved with conservative care. Early diabetic changes, diffuse and/or nodular glomerulosclerosis were present in 3.1% and 96.9% of diabetic patients, respectively. Biopsies with diabetic changes with other nondiabetic pathologies were 3% of the biopsies. Isolated nondiabetic nephropathy was found in 23.7% of patients. Pathologic findings other then diabetic changes were as follows in patients without diabetic nephropathy: focal segmental glomerulosclerosis (FSGS) 49.5%, membranous glomerulonephritis 14,1%, Ig A nephropathy 12,1%, membranoproliferative glomerulonephritis 5 %, crescentic glomerulonephritis 4,1%, acute tubular necrosis 4,1%, amyloidosis 3%, tubulointerstitial damage 2%, others 6,1%. Conclusion Biopsy in diabetic patients is beneficial to show both diabetic nephropathy and other kidney pathologies. Kidney biopsy may be performed if there is suspicion of other glomerular pathologies. Focal segmental sclerosis was the most common pathology in our patients without diabetic nephropathy


2021 ◽  
Vol 18 (7) ◽  
pp. 1539-1546
Author(s):  
Sultan A.M. Saghir ◽  
Abdullah E.A. Alhariri ◽  
Sameer A. Alkubat ◽  
Amer A. Almiamn ◽  
Saleem H. Aladaileh ◽  
...  

Purpose: To determine the status of glycemic control and its associated factors among adult patients with type 2 diabetes mellitus (T2DM) in Hodeidah City, Yemen. Methods: This cross-sectional study involved T2DM patients attending an outpatient clinic at the Military Hospital in Hodeidah, from January to March 2017. Relevant socio-demographic characteristics, clinical factors and self-management behaviours were recorded in face-to-face interviews. Blood pressure, body weight, and height measurements were also obtained. Glycosylated hemoglobin (HbA1c) and lipid profile were evaluated. Urine samples were also obtained and analysed by albuminuria assay. Results: Of 246 participants, 73.2 % showed poor glycemic control (HbA1c ≥ 7 %). Female patients, those aged ≥ 40 years, the illiterate, and Khat chewers were more likely to have poor glycemic control. Moreover, longer disease duration, insulin administration and albuminuria were significantly associated with poor glycemic control. In contrast, a healthy diet, physical exercise, proper self-monitoring of blood glucose levels and taking medicines as prescribed significantly increased the likelihood of good glycemic control. Conclusion: A majority of the Yemeni diabetic patients have poor glycemic control. To achieve better awareness, diabetes educational programs that highlight the benefits of self-management are recommended.


2021 ◽  
Vol 19 (1) ◽  
pp. 1183-1192
Author(s):  
Ahmad El Askary ◽  
Amal F. Gharib ◽  
Mazen Almehmadi ◽  
Maha Mahfouz Bakhuraysah ◽  
Abdulaziz Ali Al Hajjiahmed ◽  
...  

Abstract Diabetic nephropathy (DN) is the leading cause of end-stage renal disease worldwide. Albuminuria is the most sensitive marker for the early recognition of DN. Therefore, we aimed to study the risk factors of albuminuria as a marker of DN among diabetic patients. The study included 41 patients with type 2 diabetes mellitus (T2DM), 50 type 2 diabetic nephropathy (T2DN) patients with macroalbuminuria, 43 T2DN patients with microalbuminuria and 38 healthy controls. Logistic regression was used to detect the most significant risk factors for albuminuria. A high statistically significant difference was found between the groups regarding age, sex, body mass index (BMI), diabetes mellitus (DM) duration, glucose, glycated haemoglobin (HbA1c), creatinine, glomerular filtration rate (GFR), lipid profile, tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), the albumin–creatinine ratio (ACR), vitamin D, total parathyroid hormone (PTH), urea, total calcium and chemerin (p < 0.001). It was found that the duration of DM, BMI, glucose, GFR, total cholesterol (TC), low-density lipoprotein (LDL), TNF-α, IL-6, CRP, ACR, vitamin D, PTH and chemerin are significant albuminuria risk factors in DN. Vitamin D deficiency and associated inflammatory mediators such as chemerin, TNF-α, IL-6 and CRP are the most essential risk factors for albuminuria in T2DM patients.


Author(s):  
Deepasha Shahi Bagzai ◽  
Darshna Jain ◽  
Anurag Kesarwani

Background: Thyroid disorders and diabetes mellitus are two common endocrine disorders that are commonly encountered in clinical practice.  The relationship between thyroid disease and diabetes is important for physicians to understand in order to provide the best treatment for both conditions. The aim of this study was to assess thyroid function in Type2 Diabetes Mellitus patients of malwa region and raise awareness about thyroid dysfunction in newly diagnosed T2DM patients. Methods: In this case control study, a total of 200 subjects were chosen. Group I consisted of 100 diagnosed type 2 diabetes cases and Group II 100 sex matched stable controls. After receiving informed consent, patients were enrolled. Thyroid dysfunction in Type2 diabetes mellitus was assessed using biochemical parameters such as fasting plasma glucose, total triiodothyronine T3, total thyroxine T4, and thyroid stimulating hormone (TSH). Results: When diabetic patients were compared to healthy controls, their fasting blood glucose and serum TSH levels were substantially higher. In these two classes, however, there was no substantial difference in serum T3 and T4 levels. The findings suggest that diabetic patients have subclinical hypothyroidism as opposed to the control group in the study population Conclusion: From this current study it has been observed that thyroid function levels were altered in Diabetes mellitus patients, especially TSH levels. so it is suggested that diabetes mellitus patients should be screened for thyroid function studies on a regular basis to prevent further complications of thyroid dysfuction. Keywords: Type 2 diabetes mellitus, Thyroid dysfunction.


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