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Observational Study
. 2019 May 2;14(5):e0216151.
doi: 10.1371/journal.pone.0216151. eCollection 2019.

Prevalence of thyroid dysfunction in older Chinese patients with type 2 diabetes-A multicenter cross-sectional observational study across China

Yu Zhu  1 , Fengmei Xu  2 , Jie Shen  3 , Youshuo Liu  4 , Changhua Bi  5 , Jing Liu  6 , Yufeng Li  7 , Xueqin Wang  8 , Zhengnan Gao  9 , Linlang Liang  10 , Yanyan Chen  11 , Weiping Sun  12 , Qingbo Guan  13 , Junqing Zhang  14 , Zuojie Luo  15 , Lixin Guo  16 , Xiaopin Cai  17 , Ling Li  18 , Lingling Xiu  19 , Li Yan  20 , Chunlin Li  21 , Xiaoyun Shi  22 , Mei Zhu  23 , Jian Kuang  24 , Guangwei Li  11 , Linong Ji  1
Affiliations
Observational Study

Prevalence of thyroid dysfunction in older Chinese patients with type 2 diabetes-A multicenter cross-sectional observational study across China

Yu Zhu et al. PLoS One. .

Abstract

Type 2 diabetes [T2D] and thyroid dysfunction [TD] often co-occur, have overlapping pathologies, and their risk increases with age. Since 1995, universal salt iodization has been implemented in China to prevent disorders caused by iodine deficiency. However, after two decades of implementation of universal salt iodization, the prevalence of TD in elderly Chinese patients with T2D is not well described and may have been underestimated. We conducted a questionnaire-based survey across 24 endocrinology centers in China between December 2015 and July 2016. Demographic and clinical data from 1677 patients with T2D were obtained and analyzed to examine the prevalence of TD along with T2D in these patients. We assessed TD prevalence according to the four TD subtypes [subclinical hypothyroidism, clinical hypothyroidism, subclinical hyperthyroidism, and clinical hyperthyroidism], TD history, gender, and age. The diagnosis rates were calculated for TD and also for the TD subtype. The number of patients reaching treatment goals for T2D [hemoglobin A1c <7%] and TD [normal free thyroxine and thyroid-stimulating hormone [TSH]] and the incidences of complications and comorbidities were recorded. Among the enrolled patients with T2D [N = 1677], TD was diagnosed in 23.79% [399/1677] out of which 61% (245/399) were previously diagnosed and 38.59% (154/399) were newly diagnosed cases. Subclinical hypothyroidism, clinical hypothyroidism, subclinical hyperthyroidism, and clinical hyperthyroidism were reported in 4.89%, 9.3%, 1.13%, and 3.16% of the total population, respectively. Among patients previously diagnosed with TD, the incidence in women [166/795; 20.88%] was higher than in men [79/882; 8.96%]. The treatment goals for TD and T2D were attained in 39.6% [97/245] and 34.41% [577/1677] of the cases, respectively. Diabetic complications and comorbidities were reported in 99.7% of patients, with peripheral neuropathy being the most common [43.46%] followed by cataract [24.73%]. We had found that the incidences of dyslipidemia, elevated LDL levels, and osteoporosis were significantly higher in patients with TD than those without TD. TD is underdiagnosed in elderly Chinese patients with T2D.

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Conflict of interest statement

The authors declare that no competing interests exist. Linong Ji received study funding from Merck Serono China Co. Ltd., an affiliate of Merck KGaA, Darmstadt, Germany. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Flow chart showing the distribution of the population with thyroid dysfunction [TD] among elderly Chinese patients with type 2 diabetes [T2D].
Patients with a past medical history of thyroid dysfunction [TD]. **Other types of TD such as low T3. C: clinical; SC: subclinical; hypo: hypothyroidism; hyper: hyperthyroidism.
Fig 2
Fig 2. Prevalence of diabetic complications in elderly Chinese patients with type 2 diabetes.
See this image and copyright information in PMC

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