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. 2023 Aug 7;11(8):2211.
doi: 10.3390/biomedicines11082211.

Predictive Effects of FT3/FT4 on Diabetic Kidney Disease: An Exploratory Study on Hospitalized Euthyroid Patients with T2DM in China

Xin Zhao  1 , Jianbin Sun  1 , Sixu Xin  1 , Xiaomei Zhang  1
Affiliations

Predictive Effects of FT3/FT4 on Diabetic Kidney Disease: An Exploratory Study on Hospitalized Euthyroid Patients with T2DM in China

Xin Zhao et al. Biomedicines. .

Abstract

Objective: This study aims to explore the correlation between the free-triiodothyronine (FT3)-to-free-thyroxine (FT4) ratio (FT3/FT4) and diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM).

Methods: This study retrospectively analyzed 1729 patients with T2DM hospitalized in the Department of Endocrinology, Peking University International Hospital, from January 2017 to August 2021, including 1075 males and 654 females. In accordance with the FT3/FT4, the patients were divided into three groups.

Results: (1) The levels of glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG) and postprandial blood glucose (PBG) among the three groups were significantly different, with the low FT3/FT4 group having the highest HbA1c, FBG and PBG among the three groups (F = 39.39, p < 0.01; F = 27.04, p < 0.01; F = 5.76, p = 0.03; respectively). (2) The proportion of DKD is the highest in the low FT3/FT4 group and the lowest in the high FT3/FT4 group (χ2 = 25.83, p < 0.01). (3) Logistic regression showed that low FT3/FT4 were independent risk factors for DKD (OR = 2.36, 95 CI% 1.63, 3.43; p = 0.01).

Conclusion: A decrease in the FT3/FT4 is an independent predictor of DKD occurrence in patients with T2DM.

Keywords: diabetic kidney disease; glycosylated hemoglobin; inflammation; thyroid hormone; type 2 diabetes mellitus.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(a) The ROC curve for DKD. (b) The decision curve analysis for DKD. The overall predictive accuracy of FT3/FT4 for DKD was 0.65 (95% CI 0.62, 0.68); the overall predictive accuracy of FT4 for DKD was 0.57 (95% CI 0.54, 0.60); the overall predictive accuracy of FT3 of DKD was 0.61 (95% CI 0.58, 0.64).
Figure 2
Figure 2
(a,b): The overall predictive accuracy of multivariate predictive model for the risk of DKD. (c,d): The overall predictive accuracy of multivariate predictive model for the risk of DKD excluding FT3/FT4 as independent variables.
See this image and copyright information in PMC

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