title: Subclinical hypothyroidism and the risk of chronic kidney disease in T2D subjects: A case-control and dose-response analysis.
abstract: Evidence indicated a positive association between subclinical hypothyroidism (SCH) and cardiovascular diseases. But the relationship between SCH and chronic kidney diseases (CKD) remains unclear. A case-control study was performed to ascertain this relationship followed by a meta-analysis. In this hospital-based, case-control study, we recruited 3270 type 2 diabetic patients with euthyroidism and 545 type 2 diabetic patients with SCH. All English studies were searched upon the relationship between SCH and CKD up to October 2016. Meta-analysis was performed using STATA 13.0 software. Our case-control study indicated an association between SCH and CKD in patients with type 2 diabetes [OR (95% CI): 1.22 (1.09-1.36)]. Five observational studies reporting risk of CKD in SCH individuals were enrolled. A significant relationship between SCH and CKD was shown [pooled OR 1.80, (95% CI) 1.38-2.35]. Among normal TSH range, individuals with TSH ≥3.0 μIU/ml had a significantly higher rate of CKD (Fisher exact test, P = 0.027). Dose-response linear increase of CKD events was explored [pooled OR 1.09 (95% CI): 1.03-1.16 per1 mIU/L increase of TSH]. The present evidence suggests that SCH is probably a significant risk factor of CKD in T2D. Linear trend is shown between TSH elevation and CKD in T2D. This relationship between serum TSH and renal impairment in type 2 diabetic patients needs further studies to investigate.
authors.affiliation: Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing Department of General Surgery, Weihaiwei People's Hospital, Weihai Critical Care Medicine, Beijing Jiangong Hospital Beijng Key Laboratory of Diabetes Research and Care, Beijing, China.
authors.forename: Jian-Bo
authors.initials: JB
authors.lastname: Zhou
authors.forename: Hong-Bing
authors.initials: HB
authors.lastname: Li
authors.forename: Xiao-Rong
authors.initials: XR
authors.lastname: Zhu
authors.forename: Hai-Lin
authors.initials: HL
authors.lastname: Song
authors.forename: Ying-Ying
authors.initials: YY
authors.lastname: Zhao
authors.forename: Jin-Kui
authors.initials: JK
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D003928:Diabetic Nephropathies / Q000209:etiology*; D005067:Euthyroid Sick Syndromes / Q000097:blood / Q000150:complications; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000150:complications*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000209:etiology*; D012307:Risk Factors; D013972:Thyrotropin / Q000097:blood*
chemical_list: D015415:Biomarkers; D013972:Thyrotropin