title: Can levothyroxine treatment reduce urinary albumin excretion rate in patients with early type 2 diabetic nephropathy and subclinical hypothyroidism? A randomized double-blind and placebo-controlled study.
abstract: OBJECTIVE
  To investigate the effect of levothyroxine (LT4) therapy on urinary albumin excretion rate (UAER) in early type 2 diabetic nephropathy (DN) and subclinical hypothyroidism (SCH) patients with mildly increased thyroid stimulating hormone (TSH) levels and serum thyroid peroxidase antibody (TPO-Ab) positivity.
  
  
  METHODS
  Application of randomized double-blind and placebo-controlled methods. A total of 136 normotensive patients with early type 2 DN and SCH (TSH 4.0-7.0 mIU/L and TPO-Ab positive) were selected, and were randomly divided into two groups for LT4 or placebo treatments, respectively. Changes in UAER, serum creatinine, glomerular filtration rate (GFR), blood pressure, serum uric acid and lipids in patients before and after 48 weeks of treatment were examined and compared between groups.
  
  
  RESULTS
  There were no statistically significant differences in the baseline characteristics of study participants between two treatment groups (p > 0.05 for all). After 48 weeks of treatment, compared to the placebo treatment, the LT4 treatment was more effective in reducing total cholesterol (p < 0.05). Further comparison of therapy-related differences between groups showed that the LT4 treatment was better in reducing UAER, low-density lipoprotein cholesterol and uric acid than the placebo group (p < 0.01 for all).
  
  
  CONCLUSIONS
  The LT4 treatment may decrease UAER and exert kidney protection effects in early type 2 DN and SCH patients with mildly increased TSH levels and serum TPO-Ab positivity. However, due to the short duration of follow-up and small number of cases, the results of this study need future trials with larger numbers of patients and longer follow-up periods to verify whether such a strategy can provide durable benefits.
authors.affiliation: a a Department of Endocrinology , Laiwu Hospital Affiliated to Taishan Medical College , Laiwu China.|b b Department of Endocrinology , the Affiliated Hospital of Qingdao University , Qingdao China.
authors.forename: Peng
authors.initials: P
authors.lastname: Liu
authors.affiliation: c c Department of Clinical Laboratory , Laiwu Hospital affiliated to Taishan Medical College , Laiwu China.
authors.forename: Ruidong
authors.initials: R
authors.lastname: Liu
authors.affiliation: d d Emergency Department, the Central Hospital of Tai'an , Tai'an , China.
authors.forename: Xia
authors.initials: X
authors.lastname: Chen
authors.affiliation: c c Department of Clinical Laboratory , Laiwu Hospital affiliated to Taishan Medical College , Laiwu China.
authors.forename: Yingying
authors.initials: Y
authors.lastname: Chen
authors.affiliation: a a Department of Endocrinology , Laiwu Hospital Affiliated to Taishan Medical College , Laiwu China.
authors.forename: Debao
authors.initials: D
authors.lastname: Wang
authors.affiliation: a a Department of Endocrinology , Laiwu Hospital Affiliated to Taishan Medical College , Laiwu China.
authors.forename: Fengmei
authors.initials: F
authors.lastname: Zhang
authors.affiliation: b b Department of Endocrinology , the Affiliated Hospital of Qingdao University , Qingdao China.
authors.forename: Yangang
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000328:Adult; D000418:Albumins / Q000378:metabolism; D001323:Autoantibodies / Q000097:blood; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003928:Diabetic Nephropathies / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007037:Hypothyroidism / Q000188:drug therapy*; D007668:Kidney / Q000187:drug effects; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D013974:Thyroxine / Q000494:pharmacology*; D014527:Uric Acid / Q000097:blood
chemical_list: D000418:Albumins; D001323:Autoantibodies; D008078:Cholesterol, LDL; C056626:thyroid microsomal antibodies; D014527:Uric Acid; D002784:Cholesterol; D013974:Thyroxine
keywords: Diabetic nephropathy; Levothyroxine; Subclinical hypothyroidism; Urinary albumin excretion rate