Background: Diabetes mellitus (DM) and thyroid dysfunction (TD) are two closely associated disorders. The objective of the present study was to investigate the thyroid status and the relationships between thyroid hormones, diabetic complications and metabolic parameters in hospitalized patients with newly diagnosed type 2 DM (T2DM). Methods: This was an observational cross-sectional study, conducting on 340 patients with newly diagnosed T2DM who were admitted to ward of endocrinology department and 120 matched individuals without diabetes. Anthropometric, clinical and biochemical data were collected. Spearman correlation coefficients were calculated to evaluate the correlations between thyroid hormones and other variables. Factors associated with diabetic nephropathy (DN) was analyzed with multivariate logistic regression. Results: Levels of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) were significantly lower in patients with T2DM as compared to control group without diabetes. The prevalence of TD was 21.2% in patients with diabetes, higher than that in controls (4.2%). The low T3 syndrome was the most frequent TD, shown in 14.7% of patients. The presence of diabetic complications DN, diabetic ketosis or ketoacidosis), metabolic and demographic factors, including age, glycemic control and insulin resistance were factors significantly associated with levels of thyroid hormones. FT3 level was inversely correlated with the level of urinary total protein (mg/24h) and the presence of DN. Multivariate analysis indicated low FT3 level as a strong independent risk factor (OR = 0.364, P = 0.001) for DN. Conclusion: TD is not rarely seen in hospitalized patients with newly diagnosed T2DM. Diabetic complications and diabetes-related metabolic and demographic factors are related to thyroid hormone levels. Decreased FT3 is strongly correlated with the presence of DN.

To estimate the prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) and to evaluate the associations between thyroid parameters, MAFLD and liver brosis in euthyroid patients with newly diagnosed type 2 diabetes mellitus (T2DM). MethodsOverall, 689 patients with newly diagnosed T2DM and 110 subjects without diabetes were included. All the participants were euthyroid, and were categorized as non-MAFLD and MAFLD. Demographic information, biochemical parameters, and serum thyroid hormones were collected. The thyroid hormone sensitivity indices were calculated. MAFLD was de ned according to abdominal ultrasound and clinical manifestations. Noninvasive brosis indices were calculated to identify advanced liver brosis. ResultsThe prevalence of MAFLD was signi cantly higher in patients with T2DM than in subjects without diabetes.Levels of free triiodothyronine (FT3) and FT3 to free thyroxine (FT4) ratio were signi cantly higher in subjects with MAFLD. In patients with T2DM, levels of thyroid stimulating hormone (TSH), Thyroid feedback quantilebased index (TFQI FT3 ) calculated using FT3 and TSH, thyrotroph T3 resistance index (TT3RI) and thyrotroph T4 resistance index (TT4RI) were signi cantly higher in subjects with MAFLD. The prevalence of MAFLD increased with the rise of FT3, FT3/FT4, TSH, and sensitivity to thyroid hormone indices (TFQI FT3 , TT3RI, and TT4RI).Positive correlations were signi cant between FT3, TFQI FT3 and MAFLD. But after further adjusted for BMI and HOMA-IR, the correlations were not signi cant. The incidence of advanced brosis tended to increase as the rise of TSH and sensitivity to thyroid hormone indices (TFQI FT3 , TT3RI, and TT4RI). ConclusionMAFLD was prevalent in euthyroid patients with newly diagnosed T2DM. Higher normal FT3, TSH and impaired sensitivity to thyroid hormones are associated with increased risk of MAFLD.

Background: To investigate the prevalence of euthyroid sick syndrome (ESS) and to evaluate the outcomes and risk factors associated with ESS among hospitalized patients with diabetic ketosis (DK) or diabetic ketoacidosis (DKA).Methods: Laboratory and clinical data of 396 adult hospitalized DK/DKA patients with or without ESS were collected and analyzed. Spearman linear analysis and multivariable logistic regression analyses were used to evaluate correlated factors of thyroid hormones and risk factors of ESS.Results: Most of the individuals were diagnosed with type 2 diabetes (359/396, 90.7%). The prevalence of ESS was 57.8% (229/396). Patients in ESS group were older and had a longer course of diabetes. Levels of thyroid hormones, serum lipids, and parameters reflecting acidosis were significantly decreased in ESS group. The proportion of patients with infection, acute renal injury and DKA was significantly higher in ESS group than in control group, accompanied by longer hospitalization stay and higher hospitalization costs. Free triiodothyronine was positively correlated with albumin, eGFR, parameters reflecting acidosis and lipid profiles (All P < 0.001), and was negatively correlated with age, onset age, 24-hour urine albumin, hsCRP and WBC count (All P < 0.001). Hypoalbuminemia, low level of carbon dioxide combining power, high level of HbA1c and WBC, and co-infection were shown to be risk factors for ESS (OR = 0.866, 0.933, 1.112, 1.146, 1.929, respectively; All P < 0.05).Conclusions: The prevalence of ESS was high in adult DK/DKA patients. Patients with ESS had inferior clinical and socioeconomic outcomes. Early recognition and management of patients with ESS may be necessary to improve outcome.

Background : Diabetes mellitus (DM) and thyroid dysfunction (TD) are two closely associated disorders. The coexistence of TD could adversely influence metabolic control and even increase the long-term mortality in patients with DM. The objective of the present study was to investigate the prevalence and risk factors of TD in patients with type 2 DM (T2DM). Methods : This is an observational cross-sectional study. A total of 340 patients with newly diagnosed T2DM who were admitted to ward of endocrinology department were included for analysis. Thyroid function was examined and its relationship with demographic, metabolic and diabetes-related parameters were evaluated Results : The prevalence of TD was 21.2% in the total population. The low T3 syndrome was the most frequent TD, in 14.7% of patients. Low FT3 level was associated with diabetic complications including presence of diabetic ketosis (DK) or diabetic ketoacidosis (DKA) (r = -0.388, P ≤ 0.001) and microalbuminuria (r = -0.302, P ≤ 0.001). Metabolic and demographic factors, including age, glycemic control and insulin resistance also correlated with levels of thyroid hormones. DK or DKA (OR = 6.161, P ≤ 0.001) and microalbuminuria (OR = 3.950, P = 0.002) were risk factors of low T3 syndrome. Conclusion : TD is not rarely seen in patients with newly diagnosed T2DM. Diabetic complications and diabetes-related metabolic and demographic factors are related to the presence of TD.

Background : Diabetes mellitus (DM) and thyroid dysfunction (TD) are two closely associated disorders. The coexistence of TD could adversely influence metabolic control and even increase the long-term mortality in patients with DM. The objective of the present study was to investigate the prevalence and risk factors of TD in patients with type 2 DM (T2DM). Methods : This is an observational cross-sectional study. A total of 340 patients with newly diagnosed T2DM who were admitted to ward of endocrinology department were included for analysis. Thyroid function was examined and its relationship with demographic, metabolic and diabetes-related parameters were evaluated Results : The prevalence of TD was 21.2% in the total population. The low T3 syndrome was the most frequent TD, in 14.7% of patients. Low FT3 level was associated with diabetic complications including presence of diabetic ketosis (DK) or diabetic ketoacidosis (DKA) (r = -0.388, P ≤ 0.001) and microalbuminuria (r = -0.302, P ≤ 0.001). Metabolic and demographic factors, including age, glycemic control and insulin resistance also correlated with levels of thyroid hormones. DK or DKA (OR = 6.161, P ≤ 0.001) and microalbuminuria (OR = 3.950, P = 0.002) were risk factors of low T3 syndrome. Conclusion : TD is not rarely seen in patients with newly diagnosed T2DM. Diabetic complications and diabetes-related metabolic and demographic factors are related to the presence of TD.