Association of thyroid autoantibodies and diabetic kidney disease in hospitalised patients with type 2 diabetes mellitus: a cross-sectional study from a Chinese university hospital

Abstract

Objectives: To analyse and explore the association between thyroid autoantibodies and diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM).

Design: A cross-sectional study.

Setting: Patients were from the inpatient unit at The Second Endocrinology Department of Shengjing Hospital Affiliated to China Medical University (Shenyang, China) between January 2015 and September 2019.

Participants: A total of 150 Chinese adults with T2DM were included in the study, including 83 men and 67 women. Their age ranged between 25 and 92 years.

Methodology: They grouped by the presence of DKD, urine albumin-to-creatinine ratio (UACR), estimated glomerular filtration rate, and levels of thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb). Data on the patients' general characteristics and laboratory measurements (levels of fasting plasma glucose, glycated haemoglobin, and albumin; renal function; and thyroid function) were collected. Binary logistic regression was performed to identify risk factors for DKD.

Results: The level of TPOAb, the positivity rates of TPOAb (p<0.01) and TgAb (p<0.05) were higher in patients with DKD than in those without DKD. The TPOAb level in patients with a UACR<30 mg/g creatinine was lower than that in patients with a UACR between 30 and 300 mg/g creatinine (p<0.05). The prevalence of DKD was higher in patients with a TPOAb-positive or TgAb-positive status. The result of binary logistic regression analysis showed that a TPOAb-positive status was significantly associated with DKD in patients with T2DM (OR=7.683, 95% CI 1.583 to 37.286, p<0.05).

Conclusions: TPOAb-positive status is in association with DKD in patients with T2DM. Large scale, prospective cohort studies are warranted to confirm our findings.

Keywords: diabetes & endocrinology; diabetic nephropathy & vascular disease; thyroid disease.

Figure 1

Distributions of positivity rates for TPOAb and TgAb in groups. DKD, diabetic kidney disease; NDKD, non-diabetic kidney disease; TgAb, thyroglobulin antibody; TPOAb, thyroid peroxidase antibody. *P<0.05, **p<0.01, χ² test.

Figure 2

Prevalence of DKD in the TPOAb-positive group and TgAb-positive group. DKD, diabetic kidney disease; NDKD, non-diabetic kidney disease; TgAb, thyroglobulin antibody; TPOAb, thyroid peroxidase antibody.

Figure 3

Logistic regression of DKD and thyroid function. Adjusted for sex, age, diabetes duration, diastolic blood pressure, and neuropathy. DKD, diabetic kidney disease; FT3, free triiodothyronine; FT4, free thyroxine; TgAb, thyroglobulin antibody; TPOAb, thyroid peroxidase antibody; TSH, thyroid-stimulating hormone.