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Does autoimmune hypothyroidism increase the risk of neurovascular complications in type 1 diabetes?
Journal of Endocrinological Investigation ( IF 3.9 ) Pub Date : 2020-01-03 , DOI: 10.1007/s40618-019-01171-x
A Rogowicz-Frontczak 1 , B Falkowski 1 , A Grzelka-Wozniak 1 , A Uruska 1 , A Araszkiewicz 1 , D Zozulinska-Ziolkiewicz 1
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BACKGROUND Type 1 diabetes (T1DM) often coexists with other autoimmune diseases, most commonly with hypothyroidism. To date, the influence of coexisting autoimmune hypothyroidism (AHT) on the course of chronic neurovascular complications of autoimmune diabetes has not been established. The aim of the study was to assess the relationship between AHT and the occurrence of chronic T1DM complications. METHODS The study group comprised 332 European Caucasian participants with T1DM [165 (49.7%) men]. AHT was recognized in subclinical and overt hypothyroidism and confirmed by the presence of anti-thyroid autoantibodies: anti-peroxidase (ATPO) and/or anti-thyroglobulin (ATg) and ultrasonography (hypoechogenicity, parenchymal heterogeneity, lymph nodes assessment). RESULTS In the analyzed group, 48.5% of patients were diagnosed with at least one neurovascular complication. At the time of enrollment, 16.3% of participants were diagnosed with AHT. Patients with AHT, compared to those without AHT, were characterized by a higher prevalence of neurovascular complications (64.8 vs. 45.3%; P = 0.009) and retinopathy (55.6 vs. 38.9%; P = 0.02). There were significant differences between groups with and without neurovascular complications, with regard to classic risk factors for chronic diabetes complications: age, T1DM duration, SBP, DBP, HbA1c, TG, eGFR and hypertension prevalence. In the multivariate logistic regression analysis, AHT was an independent predictor of neurovascular complications after adjusting for age, DBP, HbA1c and TG (odds ratio, 2.40; 95% confidence interval, 1.17-4.92; P = 0.02). CONCLUSIONS AHT coexisting with T1DM was associated with a higher incidence of neurovascular complications.

中文翻译:

自身免疫性甲状腺功能减退症是否会增加1型糖尿病患者神经血管并发症的风险?

背景技术1型糖尿病(T1DM)经常与其他自身免疫疾病共存,最常见的是甲状腺功能减退。迄今为止,还没有建立共存的自身免疫性甲状腺功能减退症(AHT)对自身免疫性糖尿病的慢性神经血管并发症病程的影响。该研究的目的是评估AHT与慢性T1DM并发症发生之间的关系。方法该研究组包括332名欧洲T1DM白人参与者[165(49.7%)名男性]。AHT在亚临床和明显的甲状腺功能减退症中得到公认,并被抗甲状腺自身抗体(抗过氧化物酶(ATPO)和/或抗甲状腺球蛋白(ATg))和超声检查(低生软骨性,实质异质性,淋巴结评估)证实。结果在分析组中,为48。5%的患者被诊断出患有至少一种神经血管并发症。在注册时,有16.3%的参与者被诊断出患有AHT。与没有AHT的患者相比,具有AHT的患者的特征是神经血管并发症(64.8 vs. 45.3%; P = 0.009)和视网膜病变(55.6 vs. 38.9%; P = 0.02)的患病率更高。在有和没有神经血管并发症的组之间,就慢性糖尿病并发症的经典危险因素而言,存在显着差异:年龄,T1DM持续时间,SBP,DBP,HbA1c,TG,eGFR和高血压患病率。在多元logistic回归分析中,AHT是校正年龄,DBP,HbA1c和TG后神经血管并发症的独立预测因子(优势比为2.40; 95%置信区间为1.17-4.92; P = 0.02)。
更新日期:2020-01-03
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