SUBCLINICAL HYPOTHYROIDISM IN TYPE 2 DIABETES MELLITUS: PREVALENCE AND EFFECTS ON GLYCAEMIC AND LIPID PROFILE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 46
Abstract
BACKGROUND There is a significant prevalence of thyroid disorders in patients with diabetes mellitus, the most common being subclinical hypothyroidism. The coexistence of subclinical hypothyroidism in diabetes may alter the glycaemic profile and lipid profile that is expected in these patients Objectives- To determine the prevalence of subclinical hypothyroidism in patients with type 2 diabetes mellitus and to evaluate glycaemic profile and lipid profile in patients having both the disorders. MATERIALS AND METHODS The study was done at a tertiary care hospital (Rajiv Gandhi Government General Hospital attached to Madras Medical College in the Institute of Internal Medicine). A total of 245 patients were screened during the study period between June 2016 to December 2016 and 200 patients above 40 years diagnosed to have type 2 diabetes mellitus without any previous history of thyroid dysfunction were subjected to a short relevant history and physical examination as per a set questionnaire. Liver and renal function tests, fasting thyroid profile and fasting lipid profile were taken for all patients. Those who had abnormal liver/renal function test were excluded (45 patients were excluded). The following investigations were performed for all patients: Fasting blood sugar (FBS), Haemoglobin A1c (HbA1c), Serum free T3, free T4 and thyroid stimulating hormone (TSH), complete fasting lipid profile, electrocardiogram (ECG), 2D Echocardiography, ophthalmological evaluation, urine routine, blood urea, serum creatinine, liver function tests, and serum electrolytes. RESULTS Hypothyroidism was present in 12% of cases. Prevalence was significantly higher in females (13.9%) than males (9.8%), but not statistically significant when Chi-squared test was applied (p value 0.57). The presence of subclinical hypothyroidism was significantly related to higher levels of HbA1c. The mean HbA1c in the groups with and without subclinical hypothyroidism was 8.53% and 7.93% respectively. There was no significant correlation between duration of diabetes and presence of subclinical hypothyroidism. There was a higher but insignificant prevalence of total and LDL cholesterol, and there was no significant increase in prevalence of low HDL cholesterol in patients with subclinical hypothyroidism. There was a significantly higher prevalence of hypertriglyceridaemia (64.3% versus 18.5%) and the mean value of serum triglyceride level was 184.4 mg/dL in patients with subclinical hypothyroidism versus 151.3 mg/dL among those with only diabetes. CONCLUSION There is a significant increase in the incidence of subclinical hypothyroidism in patients with type 2 diabetes mellitus, and this increase is associated with a significant rise in triglyceride levels and HbA1c levels. There is no correlation between total cholesterol, and LDL and HDL cholesterol with presence of subclinical hypothyroidism.
Authors and Affiliations
Sivaram Kannan S, Damodaran Dhanasekaran
Keywords
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- EP ID EP217358
- DOI 10.14260/Jemds/2017/773
- Views 96
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