Rising Thyroid Disorders Among Type 2 Diabetic Mellitus Patients: Case-Control Study

AIM: The objective of study to explore the association between thyroid dysfunction and Type 2 diabetes mellitus (T2DM) related to family history and co-morbid conditions.

METHODS: This was a case and control study, 762 T2DM patients and 762 control study participants were enrolled, aged between 25 and 65 years. The study based on biochemistry parameters included: fasting blood glucose levels (FBG), glycosylated hemoglobin (HbA1c), serum cholesterol, triglycerides, high density lipoprotein (HDL), low density lipoprotein (LDL), thyroid stimulating hormone (TSH), T3, and T4.

RESULTS: There were statistically significant differences between T2DM patients and control subjects regarding BMI, physical activity, smoking, metabolic syndrome, hypertension, family history thyroid nodules, and number of sleeping hours. The study found statistically significant differences between T2DM and control subjects on calcium (p=0.028), magnesium (p<0.001), potassium (p<0.001), phosphorous (p=0.038), fasting blood glucose (p<0.001), HbA1c (p<0.001), LDL (p=0.002), albumin (p<0.001), billirubin (p=0.015), triglyceride (p<0.001), SBP (p=0.009) and, DBP (p=0.002), TSH (p<0.001), T3 (p<0.001), and T4 (p<0.001). There were statistically significant differences between subjects with and those without thyroid nodules for calcium (p<0.001), magnesium (p<0.001), phosphorous (p=0.022), HDL (p=0.050), TSH (p<0.001), T3 (p<0.001), and T4 (p<0.001). Multivariable stepwise logistic regression analysis showed that TSH mIU/L ( <0.001), HbA1c ( p< 0.001), family history of thyroid (p< 0.001), Waist circumference, (p<0.001), SBP mmHg (p= 0.002), [DBP mmHg ( p= 0.003), BMI (p= 0.006), Serum Calcium level (mmol/L) (p <0.001], and family history of DM ( p= 0.015) were considered at higher risk as a predictors of thyroid amongT2DM patients.

CONCLUSION: The study found a high prevalence of thyroid dysfunction in Turkish T2DM patients compared to the general population. This study suggests that obesity, HbA1c, the environment, and genetic susceptibility among T2DM, may increase the risk of thyroid disease and cancer.