Association between Decreased Thyroid Stimulating Hormone and Hyperuricemia in Type 2 Diabetic Patients with Early-stage Diabetic Kidney Disease

Abstract

Background Serum uric acid (SUA) is associated with the development of diabetic kidney disease (DKD). Thyroid hormones can regulate metabolism and insulin resistance. The relationship between SUA and thyroid function is still uncertain. Methods 254 type 2 diabetic patients with early-stage DKD were enrolled in current study and were further classified as high SUA group (SUA > 360 µmol/L, n = 126) and normal SUA group (SUA ≤ 360 µmol/L, n = 128). 85 control subjects were recruited as control group. The clinical characteristics were obtained via face-to-face surveys and medical records. Results Compared with normal SUA group and control group, high SUA group exhibited the increased SUA, free triiodothyronine and free thyroxine levels, and the decreased thyroid stimulating hormone (TSH) level (P < 0.017 for all), and no significant difference was detected in these parameters between normal SUA group and control group. Furthermore, the increased creatinine (β = 2.049, P < 0.001), triglycerides (β = 10.068, P < 0.001), urinary albumin-to-creatinine ratio (β = 0.262, P = 0.001), fasting blood glucose (β = 5.280, P = 0.003) and fasting insulin (β = 1.440, P = 0.034) levels, and the decreased TSH (β = -24.906, P < 0.001) level were independently correlated with higher SUA level in type 2 diabetic patients with early-stage DKD. Notably, decreased TSH retained a significant association (odds ratio = 1.654, P = 0.002) with hyperuricemia in type 2 diabetic patients with early-stage DKD. Conclusions TSH is negatively correlated with SUA, and decreased TSH is an independent risk factor for hyperuricemia in type 2 diabetic patients with early-stage DKD. These results indicate that thyroid hormones, TSH in particular, might participate in regulating uric acid metabolism in patients with early-stage DKD.