Thyroid hormones and hepatorenal function in Diabetes Mellitus : A Conclusion from Indian Study.

Mohit Rojekar, Vatsal Jain, Parikshit Saklani, Sherwin Carvalho, Shivani Nirgudkar

Abstract

Background: Presence of hypothyroidism in Diabetes Mellitus (DM) is a foundation for development of complications. Thyroid hormones have been hypothesised to affect and be affected by hepatorenal function. These hypotheses warrant further study into the topic. Materials & methods: 81 diabetics and 81 age & sex-matched healthy volunteers participated in the study. Their blood samples were analysed for fasting blood glucose (FBG), glycosylated hemoglobin (HbA1C), total triiodothyronine (T3), total thyroxine (T4), free T3 (FT3), free T4 (FT4), thyroid-stimulating hormone (TSH) and liver & renal function tests. Data was analysed using appropriate statistical tests. Results: 42 males and 39 females each were recruited as cases and controls. FBG, HbA1c, FT4, TSH, serum alanine transaminase (ALT), alkaline phosphatase (ALP) and serum creatinine (CR) were higher in diabetics. T3 and FT3 were lower in diabetics. T3, FT3, and albumin (ALB) were lower in diabetics with CR ≥ 1.30 mg/dL. FBG, direct bilirubin (DBIL), ALP and CR were higher and T3 and FT3 were lower in hypoproteinemic diabetics. Total proteins (TPRO) and ALB positively correlated with T3 and FT3. TBIL positively correlated with FBG. ALP positively correlated with HbA1c. Conclusion: Hypoproteinemia predicts poor glycemic control, renal dysfunction and hypothyroidism. High-normal circulating levels of T3 and FT3 being correlated with lower levels of CR may imply that a thyroid-sufficient state is largely protective against renal dysfunction in DM. In summary, routine LFT and RFT investigations can be indicative of subclinical hypothyroidism and thus an underlying cause of resistance to anti-hyperglycemic therapy; treating the same may improve therapeutic outcomes. 
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