Objective. Features of the thyroid status in patients with type 1 diabetes (T1D) and diabetic kidney disease (DKD) are still disputable and need clarifying.

Materials and methods. We examined the thyroid profile of 166 patients with T1D. All patients were divided into 2 groups according to eGFR. Group 1 included 79 patients without kidney function change and the eGFR values higher
60 ml/min/1.73 m2; Group 2 – 87 patients having DKD and the eGFR values lower 60 ml/min/1.73 m2.

Results. The TSH levels did not differ in the studied groups, however this cannot serve as an evidence of disturbances absence in the hypothalamic-pituitary-thyroid axis in patients with DKD. Hypothyroidism occurrence (TTH>4.2 µU/ml) increased to 20.69% the GFR reducing lower 60 ml/min/1.73 m2, though the data did not differ reliably. No evident difference was revealed in the calculated indices of the peripheral conversion and integral thyroid index, the free T4, thyroglobulin, antibodies to thyroid peroxidase (Ab-R-TSH) levels. The free T3 levels were significantly higher in men than in women. The patients with T1D and low free T3 levels demonstrated the risk of anemia developing (Hb<120 g/l) 1.51 times higher (OR 1.51, 95% CI (0.74—3.07)) than the patients with the free T3 normal values.

Conclusion. The serum free T3 median values were lower in patients with DKD confirming the sensitivity of this hormonal parameter to the renal function decrease. The gender aspect was found to effect the free T3 level. In patients with DKD and anemia, the glucose control assessment using HbA1c and its prognostic value are questionable. Lower values of Ab-R-TSH in patients with DKD can determine low-normal values of the T4 and T3 free fractions and the autoimmune component absence under the eGFR decreased lower 60 ml/min/1.73 m2 can confirm the DKD effect indirectly.

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Автор(ы): E. G. Sazonava, T. V. Mokhort, N. V. Karlovich