PREVALENCE AND ASSOCIATION OF SUBCLINICAL HYPOTHYROIDISM IN ADULT PATIENTS WITH DIABETES MELLITUS IN A TERTIARY CARE HOSPITAL

Abstract

Introduction: Diabetes and thyroid disease are two of the most common types of endocrine metabolic diseases.The prevalence of SCH is more in patients with T2DM (2.2% to 17%) than the general population (4 to 10%). Research have shown that the thyroid hormone plays a role in controlling glucose metabolism and pancreatic function, while diabetes can alter thyroid function. However,the link between T2DM and related thyroid disorders remains highly debatable and human research have shown conflicting results.Hence the current study was undertaken to estimate the prevalence of SCH in type 2 DM patients also the association between the two endocrine disorders which will help in better management. Material and methods:An analytical cross-sectional study was done in 300 adult Type 2 Diabetes mellitus patients in a tertiary care during December 2021 to May 2023 after institutional ethical approval. Convenient sampling method was used. Data collection was done in a semistructured questionnaire which includes, age, sex, weight, BMI, Medical and relevant surgical and personal history. Clinical examination was done and complications if any were recorded. Statistical analysis was done using SPSS version 23. Statistical tests applied were chi square test, t test, spearmans correlation and multiple logistic regression with P<0.05 was considered as statistically significant. Results:The prevalence of subclinical hypothyroidism in this study was 16% (58/300 patients). Mean age of patients was high in patients with SCH (54.2) compared to euthyroid patients (52.7) but was not significant statistically. More proportion of females (21.6%) compared to males (12%) have SCH which was significant. Mean HbA1C, free T4 and total cholesterol was significantly more in patients with SCH compared to euthyroid patients.Spearmans rho was used to assess correlation which shows weak association of HbA1C with TSH (r=0.14/p>0.05) which was not statistically significant. Conclusons: The prevalence of subclinical hypothyroidism in this study was 16% (58/300 patients).After adjusting for age, gender, BMI, duration of diabetes mellitus, dyslipidaemia and complications due to diabetes mellitus multiple logistic regression shows the odds of having SCH is 0.9 times and 1.2 times in patients with HbA1C 7-9%and >9%, when HbA1C <7% was considered as reference which was significant statistically.