Prevalence and Clinical Significance of Subclinical Hypothyroidism in Diabetic Peripheral Neuropathy

Allam, Mahmoud A.; Nassar, Youssef; Shabana, H; Mostafa, Sadek; Khalil, Farag; Zidan, Hendawy; Abo-Ghebsha, Mohammed; Abdelghaffar, Amir; Essmat, Ahmed; Elmahdi, Essam

doi:10.2147/ijgm.s337779

Cited by 8 publications

(6 citation statements)

References 43 publications

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“…Cross-sectional studies showed that subclinical hypothyroidism was highly prevalent in patients with DR and DPN, and was closely related to their severity. [44][45][46] Low FT3 within the normal range was also indicated to be independently associated with DR 10 and DPN 47 in euthyroid patients with T2DM in recently researches. But notably, the relationships between thyroid hormone levels and diabetic microvascular complications such as DR were found to be weak or negative in some researches 48 and there is a lack of large-scale prospective clinical research on the impact of thyroid on the occurrence and course of diabetic chronic complications.…”

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confidence: 92%

Evaluation of the Thyroid Characteristics and Correlated Factors in Hospitalized Patients with Newly Diagnosed Type 2 Diabetes

Li¹,

Yi²,

Deng³

et al. 2022

DMSO

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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.

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confidence: 92%

Evaluation of the Thyroid Characteristics and Correlated Factors in Hospitalized Patients with Newly Diagnosed Type 2 Diabetes

Li¹,

Yi²,

Deng³

et al. 2022

DMSO

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“…Clinical and subclinical hypothyroidism (SCH) in patients with diabetes mellitus is quite common in patients with DPN and is strongly associated with the severity of DPN ( 149 ). In several studies investigating the relationship between TSH and DPN in patients with T2DM, TSH levels were found to be positively correlated with DPN ( 150 – 152 ).…”

Section: Mechanismmentioning

confidence: 99%

Diabetic peripheral neuropathy: pathogenetic mechanisms and treatment

Zhu,

Hu,

Luo

et al. 2024

Front. Endocrinol.

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Diabetic peripheral neuropathy (DPN) refers to the development of peripheral nerve dysfunction in patients with diabetes when other causes are excluded. Diabetic distal symmetric polyneuropathy (DSPN) is the most representative form of DPN. As one of the most common complications of diabetes, its prevalence increases with the duration of diabetes. 10-15% of newly diagnosed T2DM patients have DSPN, and the prevalence can exceed 50% in patients with diabetes for more than 10 years. Bilateral limb pain, numbness, and paresthesia are the most common clinical manifestations in patients with DPN, and in severe cases, foot ulcers can occur, even leading to amputation. The etiology and pathogenesis of diabetic neuropathy are not yet completely clarified, but hyperglycemia, disorders of lipid metabolism, and abnormalities in insulin signaling pathways are currently considered to be the initiating factors for a range of pathophysiological changes in DPN. In the presence of abnormal metabolic factors, the normal structure and function of the entire peripheral nervous system are disrupted, including myelinated and unmyelinated nerve axons, perikaryon, neurovascular, and glial cells. In addition, abnormalities in the insulin signaling pathway will inhibit neural axon repair and promote apoptosis of damaged cells. Here, we will discuss recent advances in the study of DPN mechanisms, including oxidative stress pathways, mechanisms of microvascular damage, mechanisms of damage to insulin receptor signaling pathways, and other potential mechanisms associated with neuroinflammation, mitochondrial dysfunction, and cellular oxidative damage. Identifying the contributions from each pathway to neuropathy and the associations between them may help us to further explore more targeted screening and treatment interventions.

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Section: Research Questionmentioning

confidence: 99%

“…DPN has a high disability rate, consumes a lot of medical expenses and causes a great impact on the physical and mental HRQOL of patients (Allam et al, 2021 ; Riandini et al, 2018 ; Yang et al, 2022 ). Although DPN is gradually receiving more and more attention, current studies on DPN patients are still inadequate.…”

Section: Introductionmentioning

confidence: 99%

Correlation between health literacy and health‐related quality of life in patients with diabetic peripheral neuropathy: The mediating role of self‐management

Gao

Yan

et al. 2022

Nursing Open

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Aim The aims of the study were to analyse the current situation of health literacy (HL), self‐management and health‐related quality of life (HRQOL) in patients with diabetic peripheral neuropathy (DPN), to explore the correlation between the three and to verify the mediating role of self‐management in HL and HRQOL. Design A cross‐sectional survey. Methods The convenience sampling method was used to select 401 DPN patients attending the First Hospital of Jinzhou Medical University in Liaoning Province, China, from December 2020 to December 2021 as the study population. The research instrument included socio‐demographic characteristics questionnaire, Health Literacy Management Scale (HeLMS), Summary of Diabetes Self‐Care Activities (SDSCA) and Short‐Form 12‐item Health Survey (SF‐12). SPSS 25.0 was applied to the data for descriptive analysis, Pearson correlation analysis and stratified multiple regression analysis. Mediating effects were tested using SPSS PROCESS macro 4.0 software. Results HL and self‐management of DPN patients correlated positively with HRQOL. The mediation role of self‐management was significant in the relationship between HL and physical and mental HRQOL (physical component summary: β = 0.26, P < 0.01; mental component summary: β = 0.18, P < 0.01), with mediating effects accounting for 35.62% and 34.62% of the total effect. Conclusions There was a positive correlation between HL, self‐management and HRQOL in patients with DPN. Self‐management plays a partially mediating role in the relationship between HL and HRQOL in DPN patients. It means that HRQOL in this population can be improved by increasing HL and thus self‐management in DPN patients. Patient or Public Contribution None.

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Prevalence and Clinical Significance of Subclinical Hypothyroidism in Diabetic Peripheral Neuropathy

Cited by 8 publications

References 43 publications

Evaluation of the Thyroid Characteristics and Correlated Factors in Hospitalized Patients with Newly Diagnosed Type 2 Diabetes

Evaluation of the Thyroid Characteristics and Correlated Factors in Hospitalized Patients with Newly Diagnosed Type 2 Diabetes

Diabetic peripheral neuropathy: pathogenetic mechanisms and treatment

Correlation between health literacy and health‐related quality of life in patients with diabetic peripheral neuropathy: The mediating role of self‐management

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