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Should thyroid-stimulating hormone goals be reviewed in patients with Type 1 diabetes mellitus? Results from The Brazilian Type 1 Diabetes Study Group

Rodacki, M. ; Zajdenverg, L. ; Dantas, J. R. ; de Oliveira, J. E. P. ; Luiz, R. R. ; Cobas, R. A. ; Palma, C. C. S. ; Negrato, C. A. ; Gomes, M. B.

Diabetic medicine, 2014-12, Vol.31 (12), p.1665-1672 [Periódico revisado por pares]

Oxford: Blackwell Publishing Ltd

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Should thyroid-stimulating hormone goals be reviewed in patients with Type 1 diabetes mellitus? Results from The Brazilian Type 1 Diabetes Study Group
Autor: Rodacki, M. ; Zajdenverg, L. ; Dantas, J. R. ; de Oliveira, J. E. P. ; Luiz, R. R. ; Cobas, R. A. ; Palma, C. C. S. ; Negrato, C. A. ; Gomes, M. B.
Assuntos: Adolescent ; Adult ; Biological and medical sciences ; Brazil ; Child ; Cross-Sectional Studies ; Diabetes ; Diabetes Mellitus, Type 1 - complications ; Diabetes Mellitus, Type 1 - drug therapy ; Diabetes Mellitus, Type 1 - metabolism ; Diabetes. Impaired glucose tolerance ; Diabetic Nephropathies - etiology ; Diabetic Nephropathies - metabolism ; Diabetic retinopathy ; Diabetic Retinopathy - etiology ; Diabetic Retinopathy - metabolism ; Drug therapy ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Feeding. Feeding behavior ; Female ; Fundamental and applied biological sciences. Psychology ; Glomerular Filtration Rate ; Glycated Hemoglobin A - metabolism ; Hormones ; Humans ; Hypoglycemic Agents - therapeutic use ; Hypothyroidism - complications ; Hypothyroidism - metabolism ; Male ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Risk Factors ; Thyrotropin - metabolism ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Vertebrates: endocrinology ; Young Adult
É parte de: Diabetic medicine, 2014-12, Vol.31 (12), p.1665-1672
Notas: CNPq
Table S1. Independent association of TSH categories established according quintiles with diabetic retinopathy and glomerular filtrations rate < 60 mL/min in patients with T1D, after a multivariate analysis including age, gender, duration of diabetes, smoking, hypertension, hypercolesterolemia and HbA1c.
FAPERJ
ArticleID:DME12530
istex:AAAC9E6F65F4DAC14F74BB522AB6F1F52D500AA9
Brazilian Diabetes Association
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Descrição: Aims To investigate if thyroid‐stimulating hormone (TSH) levels are associated with any differences in glycaemic control or diabetes‐related complications in individuals with Type 1 diabetes. Methods This observational, cross‐sectional and multicentre study included patients with Type 1 diabetes for ≥ 5 years, with a recent TSH measurement and without a known previous thyroid disease. Patients were divided into three groups according to TSH levels: 0.4–2.5 mU/l; 2.5–4.4 mU/l; and ≥ 4.5 mU/l. Results We included 1205 individuals with a mean ± sd age of 23.8 ± 11.3 years. Seven patients had TSH levels <0.4 mU/l and were excluded from the comparison between groups. HbA1c levels, systolic and diastolic blood pressure, LDL cholesterol and disease duration were similar in all groups (P = 0.893, P = 0.548, P = 0.461, P = 0.575 and P = 0.764, respectively). The rates of diabetic retinopathy and GFR < 60/mL/min/1.73 m2 differed between groups (P = 0.006 and P < 0.001, respectively) and were lower in those with lower TSH levels. Multivariate analysis confirmed these associations. The frequencies of retinopathy and GFR < 60 mL/min/1.73 m2 were higher not only in patients with TSH ≥ 4.5 mU/l (odds ratio 1.878 and 2.271, respectively) but also in those with TSH levels of 2.5–4.4 mU/l (odds ratio 1.493 and 2.286, respectively), when compared with patients with TSH levels of 0.4–2.5 mU/l. Conclusions TSH levels of 0.4–2.5 mU/l are associated with a lower risk of diabetic retinopathy and renal failure in individuals with Type 1 diabetes, independently of glycaemic control and duration of the disease. What's new? This was the first study to show the link between thyroid function and diabetes‐related chronic complications in patients with Type 1 diabetes mellitus. Thyroid‐stimulating hormone levels 0.4–2.5 mU/l were found to be associated with a lower risk of diabetic retinopathy and renal dysfunction in individuals with Type 1 diabetes, independently of glycaemic control and the duration of diabetes.
Editor: Oxford: Blackwell Publishing Ltd
Idioma: Inglês

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Should thyroid-stimulating hormone goals be reviewed in patients with Type 1 diabetes mellitus? Results from The Brazilian Type 1 Diabetes Study Group

Rodacki, M. ; Zajdenverg, L. ; Dantas, J. R. ; de Oliveira, J. E. P. ; Luiz, R. R. ; Cobas, R. A. ; Palma, C. C. S. ; Negrato, C. A. ; Gomes, M. B.

Oxford: Blackwell Publishing Ltd

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