scholarly journals Estimation of Tissue Hypothyroidism by a New Clinical Score: Evaluation of Patients with Various Grades of Hypothyroidism and Controls1

1997 ◽  
Vol 82 (3) ◽  
pp. 771-776 ◽  
Author(s):  
Henryk Zulewski ◽  
Beat Müller ◽  
Pascale Exer ◽  
André R. Miserez ◽  
Jean-Jacques Staub
Keyword(s):  
Relaxation Time ◽  
Thyroid Hormones ◽  
Total Cholesterol ◽  
Thyroid Function ◽  
Signs And Symptoms ◽  
Clinical Score ◽  
Overt Hypothyroidism ◽  
Free T4 ◽  
Low T3 ◽  
Hypothyroid Patients

Abstract The classical signs and symptoms of hypothyroidism were reevaluated in the light of the modern laboratory tests for thyroid function. We analyzed 332 female subjects: 50 overt hypothyroid patients, 93 with subclinical hypothyroidism (SCH), 67 hypothyroid patients treated with T4, and 189 euthyroid subjects. The clinical score was defined as the sum of the 2 best discriminating signs and symptoms. Beside TSH and thyroid hormones, we measured parameters known to reflect tissue manifestations of hypothyroidism, such as ankle reflex relaxation time and total cholesterol. Classical signs of hypothyroidism were present only in patients with severe overt hypothyroidism with low T3, but were rare or absent in patients with normal T3 but low free T4 or in patients with SCH (normal thyroid hormones but elevated basal TSH; mean scores, 7.8 ± 2.7 vs. 4.4 ± 2.2 vs. 3.4 ± 2.0; P < 0.001). Assessment of euthyroid subjects and T4-treated patients revealed very similar results (mean score, 1.6 ± 1.6 vs. 2.1 ± 1.5). In overt hypothyroid patients, the new score showed an excellent correlation with ankle reflex relaxation time and total cholesterol (r = 0.76 and r = 0.60; P < 0.0001), but no correlation with TSH (r = 0.01). The correlation with free T4 was r = −0.52 (P < 0.0004), and that with T3 was r = −0.56 (P < 0.0001). In SCH, the best correlation was found between the new score and free T4 (r =− 0.41; P < 0.0001) and TSH (r = 0.35; P < 0.0005). Evaluation of symptoms and signs of hypothyroidism with the new score in addition to thyroid function testing is very useful for the individual assessment of thyroid failure and the monitoring of treatment.

scholarly journals Thyroid Function Test in Patients with Chronic Kidney Disease

2021 ◽  
pp. 150-158
Author(s):  
V. Abhinaya ◽  
S. Magesh Kumar
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Thyroid Hormones ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Thyroid Function Test ◽  
Free T4 ◽  
Cross Sectional ◽  
Male Predominance ◽  
Low T3

Background: Kidneys have a significant role in the metabolism, degradation and excretion of thyroid hormones. Both thyroid hormones and kidney functions have a multifaceted mutual interdependence. Objectives: To find out the possible association between the severity of chronic kidney disease and thyroid dysfunction; To estimate the correlation between thyroid dysfunction and various stages of chronic kidney disease. Materials and Methods: A prospective Cross-sectional study was done on 50 patients with Chronic kidney disease who were not on dialysis and fulfilled all the inclusion criteria at Saveetha medical college over a period of 6 months. Free T3, Free T4 and TSH levels were estimated for those patients. Results: Results of this study showed that majority of subjects included in our study were in the age group of 50-60 years with Male predominance. Out of 50 patients included in our study, 8 patients(16%) were found to hypothyroidism; 5 patients (10%) were having subclinical hypothyroidism; 20 patients (40%) were having low T3 syndrome and 17 patients (34%) were having normal functioning thyroid gland. Staging of CKD was done in relation to the glomerular filtration rate .Most of the patients(n=20) were in Stage 5 of Chronic kidney disease out of which 18 patients were having thyroid disorders. Conclusion: There is a positive correlation between the severity of CKD and thyroid dysfunction. Hence a routine thyroid function status should be evaluated in each and every patient of CKD to reduce the morbidity and mortality rate of CKD patients as well as reduce the social burden and health expenditure.

scholarly journals Association Between Thyroid Hormones and Lipids Stratified by Race and Sex

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A283-A283
Author(s):  
Musa Shakoor ◽  
Zahid Ahmad
Keyword(s):  
Thyroid Hormones ◽  
Total Cholesterol ◽  
Correlation Coefficient ◽  
Thyroid Function ◽  
Black Males ◽  
Thyroid Dysfunction ◽  
Thyroid Function Tests ◽  
Free T4 ◽  
Black Females ◽  
The Relationship

Abstract It has been well-established that thyroid hormones play a role in cholesterol and lipoprotein metabolism. However, there is limited data assessing the variability in the association between thyroid hormones and lipids across sex and race. We hypothesized that thyroid dysfunction is associated with changes in lipids and lipoproteins with no substantial variability in this association between races and sex. The electronic medical record of a large county hospital in Dallas, TX was queried to obtain data on all patients who had lipid panels and thyroid function tests checked on the same day from 1/1/2013 to 1/1/2018. The results were stratified into hypothyroid (TSH greater than 4.5 mcIU/L and Free T4 less than 0.8 ng/dL), hyperthyroid (TSH less than 0.5 mcIU/L and Free T4 greater than 1.8 ng/dL) and normal (TSH between 0.5 and 4.5 mcIU/L, Free T4 between 0.8 and 1.8 ng/dL). Results consistent with subclinical thyroid disease were excluded from further analysis. There were 25,290 unique results for thyroid hormones and lipid panels checked on the same day. The results were further stratified by race and sex, and the relationship between thyroid function and lipids was assessed. The correlation coefficient (r) was compared between sexes within each race for the following variables: TSH vs HDL-C, TSH vs LDL-C, TSH vs Total Cholesterol, TSH vs triglycerides, FT4 vs HDL-C, FT4 vs LDL-C, FT4 vs Total Cholesterol, and FT4 vs triglycerides. Among black males with hypothyroidism, there was a notably stronger correlation when compared to black females in the relationship between TSH vs LDL-C, and TSH vs Total Cholesterol. Specifically, the correlation coefficient of TSH vs LDL-C among Black males with hypothyroidism was 0.582, compared to 0.133 among Black females with hypothyroidism (P=0.0053). Furthermore, the correlation coefficient of TSH vs Total Cholesterol among Black males was 0.567 compared to 0.184 among Black females (P=0.016). In contrast, no difference in any of the relationships between thyroid and lipids was demonstrated between sexes amongst Whites, Asians, and Hispanics. Overall, we found differences in Black patients compared to patients of other races with regards to the association between thyroid and lipids. Specifically, it was found that Black males with hypothyroidism had a stronger positive correlation in TSH vs LDL-C and TSH vs Total Cholesterol than Black females. This type of difference between sexes was not found amongst any other race. These findings suggest that thyroid dysfunction is associated with changes in lipids, and the way these changes manifest may vary depending on the race and sex. This further highlights the importance of checking lipid panels in patients with thyroid dysfunction. Further research is needed to more clearly characterize the variation that is seen in thyroid and lipid function amongst races.

THYROID DYSFUNCTION IN PATIENTS WITH CHRONIC KIDNEY DISEASE: THE STATE OF THE PROBLEM AND THE WAYS OF SOLVING

2018 ◽  
Vol 22 (4) ◽  
pp. 40-49 ◽  
Author(s):  
A. R. Volkova ◽  
O. D. Dygun ◽  
B. G. Lukichev ◽  
S. V. Dora ◽  
O. V. Galkina
Keyword(s):  
Chronic Kidney Disease ◽  
Thyroid Gland ◽  
Kidney Disease ◽  
Thyroid Hormones ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
The Body ◽  
Type I ◽  
Low T3 ◽  
Iodine Excretion

Disturbance of the thyroid function is often detected in patients with different profiles. A special feature of patients with chronic kidney  disease is the higher incidence of various thyroid function  disturbances, especially hypothyroidism. It is known that in patients  with chronic kidney disease (CKD) iodine excretion from the body is  violated, since normally 90% of iodine is excreted in urine.  Accumulation of high concentrations of inorganic iodine leads to the  formation of the Wolf-Chaikoff effect: suppression of iodine  organization in the thyroid gland and disruption of the thyroid  hormones synthesis. Peripheral metabolism of thyroid hormones is  also disturbed, namely, deiodinase type I activity is suppressed and  peripheral conversion of T4 into T3 is inhibited (so-called low T3  syndrome). Therefore, patients with CKD are often diagnosed with  hypothyroidism, and the origin of hypothyroidism is not always  associated with the outcome of autoimmune thyroiditis. The article  presents an overview of a large number of population studies of  thyroid gland dysfunction in patients with CKD, as well as  experimental data specifying the pathogenetic mechanisms of  thyroid dysfunction in patients with CKD. Therapeutic tactics are still  not regulated. However, in a number of studies, replacement therapy with thyroid hormones in patients with CKD had some advantages.

STUDY OF GHRELIN LEVELS IN HYPOTHYROID PATIENTS BEFORE AND AFTER TREATMENT

2021 ◽  
pp. 52-54
Author(s):  
Peeyush Yadav ◽  
G. G. Kaushik
Keyword(s):  
Treatment Group ◽  
Thyroid Hormones ◽  
Hdl Cholesterol ◽  
Metabolic Disturbances ◽  
Free T4 ◽  
Before And After ◽  
Group A ◽  
Group B ◽  
Serum Ghrelin ◽  
Hypothyroid Patients

Objective: Aim of the present study was to evaluate the levels of ghrelin in hypothyroid patients before and after treatment with L-thyroxine and to nd a possible relationship between ghrelin and thyroid hormones. Material & Methods: The present study was conducted on 100 hypothyroid patients (44 Males & 56 Females) before treatment (Group A) and after treatment (Group B) attending the outpatient clinics or admitted in wards of J.L.N. Hospitals, Ajmer. 100 healthy control subjects (Group C) of same age group of either gender were selected for the study. Blood samples were drawn from patients and controls, after overnight fast of at least 8 hours. Estimation of Serum Ghrelin, free T3, free T4, and TSH was done by using Enzyme- Linked Immunosorbant Assay (ELISA) technique. Total Cholesterol, Triglyceride, HDL – Cholesterol were measured by automated analyser (Beckman & Coulter's AU680). VLDL – Cholesterol, LDL – Cholesterol were calculated by Friedwald's formula. Differences in the parameters among the groups were analyzed by ANOVA test followed by its Tukey HSD post hoc analysis. Correlations between variables were tested using the Pearson rho (r: Correlation coefcient) correlation test. Results: Findings of the present study shows that the levels of serum fT3 (1.79 ± 0.29 pg/mL) and serum fT4 (0.34 ± 0.11 ng/dL) were signicantly lower in Group A compared to Group B (fT3 = 3.00 ± 0.32 pg/mL & fT4 = 0.81 ± 0.15 ng/dL) and Group C (fT3 = 3.12 ± 0.31 pg/mL & fT4 = 0.85 ± 0.11ng/dL) whereas serum TSH levels were signicantly higher in Group A (40.59 ± 13.55 μIU/mL) compared to Group B (5.34 ± 1.47 μIU/mL) and Group C (3.23 ± 1.04 μIU/mL). Levels of serum Ghrelin were signicantly higher in Group A (918.19 ± 48.47 pg/mL) compared to Group B (700.34 ± 46.35 pg/mL) and Group C (681.49 ± 35.80 pg/mL). A non signicant correlation of Ghrelin with S.fT4 and TSH was found in both Group A and Group B whereas S.fT3 and BMI shows a non signicant correlation in Group A in comparison to a signicant correlation in Group B. Conclusion: There is a reversible increase in the levels of serum ghrelin which became normalized after L-thyroxine substitution in hypothyroid patients. Alteration in the levels of serum ghrelin in thyroid disorders indicates a compensatory role of ghrelin in metabolic disturbances and also suggests a possible association between thyroid hormones and serum ghrelin levels.

scholarly journals Thyroid Function and Lipid Subparticle Sizes in Patients with Short-Term Hypothyroidism and a Population-Based Cohort

2008 ◽  
Vol 93 (3) ◽  
pp. 888-894 ◽  
Author(s):  
Elizabeth N. Pearce ◽  
Peter W. F. Wilson ◽  
Qiong Yang ◽  
Ramachandran S. Vasan ◽  
Lewis E. Braverman
Keyword(s):  
Total Cholesterol ◽  
Thyroid Function ◽  
Low Density Lipoprotein ◽  
Cohort Analysis ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Overt Hypothyroidism ◽  
Resonance Spectroscopy ◽  
Low Density ◽  
Short Term

Abstract Context: Relations between thyroid function and lipids remain incompletely understood. Objective: Our objective was to determine whether lipoprotein subparticle concentrations are associated with thyroid status. Design and Setting: We conducted a prospective clinical study and cross-sectional cohort analysis at a university endocrine clinic and the Framingham Heart Study. Subjects: Subjects included 28 thyroidectomized patients with short-term overt hypothyroidism and 2944 Framingham Offspring cohort participants. Main Outcome Measures: Fasting subclass concentrations of very-low-density lipoprotein (VLDL), intermediate-density lipoprotein, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) particles were measured by nuclear magnetic resonance spectroscopy. TSH values were also measured. Results: Total cholesterol and LDL-C were increased during short-term overt hypothyroidism. Large LDL subparticle concentrations increased during hypothyroidism (917 ± 294 vs. 491 ± 183 nmol/liter; P < 0.001), but more atherogenic small LDL was unchanged. Triglycerides marginally increased during hypothyroidism, small VLDL particles significantly increased (P < 0.001), whereas more atherogenic large VLDL was unchanged. Total HDL-C increased during hypothyroidism (76 ± 13 mg/dl vs. 58 ± 15 mg/dl; P < 0.001). There was no change in large HDL-C particle concentrations, whereas small (P < 0.001) and medium (P = 0.002) HDL-C particle concentrations decreased. Among Framingham women, adjusted total cholesterol and LDL-C were positively related to TSH categories (P ≤ 0.003). This was due to a positive correlation between adjusted large LDL subparticle concentrations and log-TSH (P < 0.0001); log small LDL subparticle concentrations decreased slightly as log-TSH increased (P = 0.045). Among Framingham men, the only significant association was a positive association between log-TSH and log large HDL subparticle concentrations (P = 0.04). Conclusions: There is a shift toward less atherogenic large LDL, small VLDL, and large HDL subparticle sizes in hypothyroid women.

THYROID FUNCTION AND PLASMA CYCLIC AMP RESPONSE TO INTRAVENOUS GLUCAGON

1977 ◽  
Vol 85 (4) ◽  
pp. 760-768 ◽  
Author(s):  
S. Nistrup Madsen
Keyword(s):  
Cyclic Amp ◽  
Thyroid Hormones ◽  
Thyroid Function ◽  
Healthy Subjects ◽  
Blood Levels ◽  
Sensitive Test ◽  
Normal Response ◽  
Hypothyroid Patients ◽  
Hyperthyroid Patients

ABSTRACT The glucagon stimulated increase in plasma cyclic AMP has been studied in 17 healthy subjects, in 13 hyperthyroid and in 14 hypothyroid patients. Six hyperthyroid and 2 hypothyroid patients were re-investigated after at least 15 months of treatment. The results show: 1) The glucagon stimulated cyclic AMP response is significantly increased in hyperthyroid patients considered as a group, and is reduced in patients with hypothyroidism. 2) Three hyperthyroid and 4 hypothyroid patients showed a normal response to iv glucagon, indicating that the plasma cyclic AMP response to iv glucagon is not a sensitive test for the evaluation of peripheral thyroid states. This suggests that the effects of thyroid hormones in the liver does not necessarily follow the effects in other tissues. 3) Re-investigation of treated patients showed that the cyclic AMP response can be normalized by treatment, both in hyperthyroidism and in hypothyroidism. However, in patients treated for hyperthyroidism a hyper-response to glucagon can continue after blood levels of thyroid hormones are reduced to normal. This suggests an inertia in the loss of the hyper-response to glucagon, once a hyperfunction has been induced. A similar inertia in the loss of glucagon sensitivity in hypothyroidism could explain the large number of normal tests in hypothyroid patients.

scholarly journals SAT-449 Factors Associated with Reduced Thyroid Hormones in Cushing Syndrome Patients Before and After Surgical Cure

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Skand Shekhar ◽  
Raven McGlotten ◽  
Lynnette K Nieman
Keyword(s):  
Thyroid Hormones ◽  
Thyroid Function ◽  
Cushing Syndrome ◽  
Hormone Secretion ◽  
Free T4 ◽  
Curative Surgery ◽  
Duration Of Symptoms ◽  
Free Cortisol ◽  
Hpt Axis ◽  
Pearson Correlations

Abstract Background: Hypercortisolemia adversely affects thyroid hormone secretion. We previously described the temporal pattern of thyroid function recovery in 23 patients (1). However, the factors leading to suppression and recovery of the hypothalamic-pituitary-thyroid (HPT) axis in Cushing’s syndrome (CS) are not fully understood. We performed two separate studies to investigate these factors. Methods: In study 1, we examined patients (pts, n=62) with CS who underwent curative surgery and recorded their serum morning and evening cortisol, ACTH, tumor volume and duration of symptoms and 24-hour urine free cortisol (UFC) at baseline and the morning serum free T4, TSH and T3 at six-month intervals after cure. Data were log-transformed and Pearson correlations were performed. Linear mixed models were used to study factors that predict recovery of thyroid function. In study 2, we examined the diurnal variation of TSH by performing hourly TSH measurement between 3—7 PM and 12—4 AM on a cohort of pts (n=45) before surgery. Wilcoxon Signed-Rank method was used for comparisons of mean TSH across time and Pearson correlations were performed on log-transformed data. P values <.05 were considered significant. Results: Study 1: In this larger cohort, we confirmed previous findings of suppressed or low normal fT4 and TSH values with active hypercortisolism, with normalization after cure that reflected changes in the T3:TSH, fT4:TSH and T3:fT4 ratios. There were inverse linear correlations between log10 UFC, serum AM and PM cortisol; and log10 TT3, fT4 and TSH before surgery. Independent negative prognosticators of circulating fT4 recovery included UFC greater than 1000mcg/day (nl: 3.5—45mcg/day), duration of symptoms of less than one year, and ACTH levels greater than 60pg/mL(nl: 5—45pg/mL) Study 2: The nocturnal (12 - 4AM) TSH surge was reduced, so that the difference in day and night TSH values was not statistically significant; this contrasts with the 30—50% nocturnal TSH increase above daytime values seen in healthy subjects. There was an inverse relationship between UFC and nocturnal TSH, daytime TSH and TBG values, but there was no direct relationship between UFC and percent changes in nocturnal TSH values. Conclusions: Our findings suggest that a deficit in TSH stimulation of the thyroid gland may explain the reduction in T3 and T4 levels. There is a dose-response relationship between various measures of hypercortisolemia and both thyroid hormones and the pattern of TSH secretion. Finally, the severity of hypercortisolism correlates with a longer time to recovery of the HPT axis in pts with CS after curative surgery. 1. Shekhar S et al. HPG and HPT Axes in Cushing Syndrome. J Endocr Soc, 3 S1, April May 2019

scholarly journals Determinants of deranged thyroid function parameters in children admitted for management of diabetic ketoacidosis/diabetic ketosis

2020 ◽  
Author(s):  
Peng Shao ◽  
Shujuan Guo ◽  
Guimei Li ◽  
Daogang Qin ◽  
Sen Li ◽  
...  
Keyword(s):  
Diabetic Ketoacidosis ◽  
Thyroid Function ◽  
Glycosylated Hemoglobin ◽  
Overt Hypothyroidism ◽  
Thyroid Function Tests ◽  
Hydroxybutyric Acid ◽  
Free T4 ◽  
Free Thyroid Hormones ◽  
Euthyroid Sick Syndrome ◽  
Diabetic Ketosis

Abstract Background: Sick euthyroid syndrome is frequent in children admitted with diabetic ketoacidosis/diabetic ketosis (DKA/DK). This study evaluates the interplay of various metabolic factors with occurrence of deranged thyroid function tests in children admitted for management of DKA/DK.Methods: 98 DKA and 96 DK children patients were selected from hospital records, among which individuals on thyroxine replacement, with overt hypothyroidism or positive anti-thyroperoxidase (TPO) antibody were excluded. Tests for liver function, renal function, lipid profile, serum osmolarity, thyroid function, c-peptide levels, and glycosylated hemoglobin were done for all. Children were divided into euthyroid (n=88) and euthyroid sick syndrome（ESS）groups (n=106).Results: The ESS group had a higher level of white blood cell count (WBC), plasma glucose (PG), beta-hydroxybutyric acid (β-HB), triglyceride (TG), anion gap (AG), glycosylated hemoglobin (HbA1c) and a lower level of HCO3-, prealbumin (PA), and albumin (ALB) compared with the euthyroid group (P<0.05). Free T3 (FT3) levels were significantly correlated to β-HB, HCO3-, AG, PA, and HbA1c (r=-0.642, 0.681, -0.377, 0.581, -0.309, respectively; P<0.01). Free T4 （FT4） levels were significantly correlated to β-HB, HCO3-, and ALB levels (r=-0.489, 0.338, 0.529, respectively; P<0.01). TSH levels were significantly affected by HCO3– only (r=-0.28; P<0.01). HCO3– level was the most important factor deciding euthyroid or ESS on logistic regression analysis (OR=0.844, P=0.004, 95%CI=0.751­-0.948).Conclusions: Lower levels of free thyroid hormones and occurrence of ESS were associated with a higher degree of acidosis in children with DKA/DK.

scholarly journals ASSOCIATION OF HYPOTHYROIDISM IN TYPE 2 DIABETES MELLITUS AND DIABETIC KIDNEY DISEASE

2020 ◽  
pp. 1-2
Author(s):  
Anjana jose ◽  
J.K. Mukkadan* ◽  
Manju kamal
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Thyroid Hormones ◽  
Subclinical Hypothyroidism ◽  
Overt Hypothyroidism ◽  
Thyroid Disorder ◽  
Low T3

Diabetes mellitus (DM) has emerged as a major public health problem in India. Diabetic nephropathy have higher prevalence of thyroid disorder when compared with diabetes mellitus. The present study compared the levels of thyroid hormones between type 2 diabetes mellitus with and without diabetic nephropathy. Among 192 diabetes mellitus patients those who have nephropathy, euthyroid was 124(64.6%), low T3 was 14(7.3%), subclinical hypothyroidism was 36(18.8%) and overt hypothyroidism was 18(9.4%) and other 192 patients those who haven't nephropathy, euthyroid was 159(82.8%), low T3 was 7(3.6%), subclinical hypothyroidism was 11(5.7%) and overt hypothyroidism was 15(7.8%). We found a statistically signicant correlation between TSH and urine protein creatinine ratio (urine PCR). Routine assessment of thyroid hormones in patients will help to improve general wellbeing and reduce the mortality risk.

scholarly journals Association between thyroid hormones and diabetic complications in patients with newly diagnosed type 2 diabetes: A cross-sectional study

2021 ◽  
Author(s):  
Yanli Li ◽  
Min Yi ◽  
Xiaoyi Deng ◽  
Wangen Li ◽  
Yimei Chen ◽  
...  
Keyword(s):  
Thyroid Hormones ◽  
Diabetic Complications ◽  
Demographic Factors ◽  
Cross Sectional Study ◽  
Newly Diagnosed ◽  
Sectional Study ◽  
Free T4 ◽  
Cross Sectional ◽  
Low T3

Abstract Background Diabetes mellitus (DM) and thyroid dysfunction (TD) are two closely associated disorders. The coexistence of TD could adversely influence metabolic control and even increase the long-term mortality in patients with DM. The objective of the present study was to investigate the thyroid status and the relationship between thyroid hormones, diabetic complications and metabolic parameters in patients with newly diagnosed type 2 DM (T2DM). Methods This is an observational cross-sectional study, conducting on 340 patients with newly diagnosed T2DM who were admitted to ward of endocrinology department and 120 matched nondiabetic subjects. Clinical characteristics were collected and laboratory measurements were conducted. Results Levels of free T3 (FT3), free T4 (FT4) and TSH were significantly lower in patients with T2DM as compared to nondiabetic subjects. The prevalence of TD was 21.2% in patients with diabetes, higher than that of controls (4.2%). The low T3 syndrome was the most frequent TD, shown in 14.7% of patients. The presence of diabetic complications (diabetic nephropathy (DN), diabetic ketosis), metabolic and demographic factors, including age, glycemic control and insulin resistance were factors associated with levels of thyroid hormones. FT3 level was inversely correlated with the level of urinary total protein (mg/24h) and the presence of DN. Multivariate analysis indicated low FT3 level as a strong independent risk factor (OR = 0.364, P < 0.001) for DN. Conclusions TD is not rarely seen in patients with newly diagnosed T2DM. Diabetic complications and diabetes-related metabolic and demographic factors are related to TD. Decreased FT3 is strongly correlated with the presence of DN.

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