title: Subclinical hypothyroidism and diabetic nephropathy in Iranian patients with type 2 diabetes.
abstract: OBJECTIVE
  Association of subclinical hypothyroidism with type 2 diabetes and its complications has been previously documented. These reports were, however, inconclusive and mainly gathered from Chinese and East Asian populations. In this study, we aimed to determine the prevalence of subclinical hypothyroidism and its relationship with diabetic nephropathy in Iranian individuals with type 2 diabetes, drawn from a white Middle Eastern population with an increasing prevalence of diabetes.
  
  
  METHODS
  In this cross-sectional study, 255 Iranian participants with type 2 diabetes and without history of thyroid disorders were included. Patients with TSH > 4.2 mIU/L and normal T4 were classified as having subclinical hypothyroidism. Diabetic nephropathy was diagnosed based on abnormal 24-h urinary albumin or protein measurements (24-h urinary albumin ≥30 mg/day or 24-h urinary protein ≥150 mg/day). Multivariate logistic regression was employed to obtain the OR for the relationship between subclinical hypothyroidism and diabetic nephropathy.
  
  
  RESULTS
  We found that subclinical hypothyroidism and diabetic nephropathy were as prevalent as 18.1 and 41.2 %, respectively, among the participants. We also found that subclinical hypothyroidism was independently associated with higher rates of diabetic nephropathy, after multivariable adjustment (OR [95 % CI] 3.23 [1.42-7.37], p = 0.005).
  
  
  CONCLUSIONS
  We found that the prevalence of subclinical hypothyroidism in Iranian diabetic population was among the highest rates reported to date. Our data supported the independent association of subclinical hypothyroidism with diabetic nephropathy, calling for further investigations to evaluate their longitudinal associations.
authors.affiliation: Department of Endocrinology and Metabolism, AJA University of Medical Sciences, P.O.BOX: 141171-8541, Tehran, Iran.
authors.forename: N
authors.initials: N
authors.lastname: Mansournia
authors.affiliation: Department of Endocrinology and Metabolism, AJA University of Medical Sciences, P.O.BOX: 141171-8541, Tehran, Iran. mohamad.riaahi@yahoo.com.
authors.forename: S
authors.initials: S
authors.lastname: Riyahi
authors.affiliation: Department of Internal Medicine, AJA University of Medical Sciences, Tehran, Iran.
authors.forename: S
authors.initials: S
authors.lastname: Tofangchiha
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: M A
authors.initials: MA
authors.lastname: Mansournia
authors.affiliation: School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Riahi
authors.affiliation: Department of Endocrinology and Metabolism, Zahedan University of Medical Sciences, Zahedan, Iran.
authors.forename: Z
authors.initials: Z
authors.lastname: Heidari
authors.affiliation: Department of Anesthesiology, AJA University of Medical Sciences, Tehran, Iran.
authors.forename: E
authors.initials: E
authors.lastname: Hazrati
mesh_terms: D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood
chemical_list: D013972:Thyrotropin; D013974:Thyroxine
keywords: Diabetic nephropathy; Microvascular complication; Middle East; Subclinical hypothyroidism; Type 2 diabetes