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Free thyroxine and triiodothyronine are associated with renal function in normoalbuminuric euthyroid type 1 diabetic patients

Study included 272 normoalbuminuric T1DM with normal thyroid function and before any interventions with statins and antihypertensive medications including those that might affect renal function (ACE inhibitors or angiotensin II receptor blockers). Euthyroidism was defined as TSH, fT3 and fT4 within the normal reference range. Urinary albumin excretion rate (UAE) was measured from at least two 24-h urine samples. Study included patients with glomerular filtration rate (GFR) > 60 mlmin-11.73m-2, estimated with Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. RESULT AND CONCLUSION The average age was approximately 34 years and 55% of subjects were male. Mean/median values of BMI (24 kg/m2), systolic and diastolic blood pressure (120/80 mmHg), HDL cholesterol (1.6 mmol/L), and triglycerides (0.9 mmol/L) were within the normal range for T1DM, with slightly elevated HbA1c (7.3%) and LDL cholesterol (2.7 mmol/L) levels. fT4 significantly correlated with serum creatinine, eGFR and UAE (r=-0.12, 0.34 and -0.13, respectively, for all p<0.05), TSH significantly correlated with UAE (r=-0.15, p<0.05) and fT3 with serum creatinine (r=0.12, p<0.05). eGFR levels were significantly higher in subjects in the highest quartile of fT4 compared to those in lowest quartile (116 vs 101 ml min-1 1.73m-2, p<0.001). In logistic regression analysis, after adjustment for age, sex, BMI, duration of diabetes and HbA1c, fT3 and fT4 were significantly associated with risk of progression of renal function in our subjects, with odds ratios of 0.75 to 1.29. The independent relation of serum creatinine, eGFR, and UAE with fT3 and fT4 suggests that the influence of thyroid function on renal function might be present already in euthyroid range in normoalbuminuric T1DM.

thyroid functin, renal function, type 1 diabetes

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