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The effect of l-thyroxine substitution on oxidative stress in early-stage diabetic nephropathy patients with subclinical hypothyroidism: a randomized double-blind and placebo-controlled study

  • Nephrology - Original Paper
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Abstract

Purpose

To study oxidative stress status of early type 2 diabetic nephropathy (DN) patients with subclinical hypothyroidism (SCH) and to assess effect of l-thyroxine therapy on the oxidative stress in these patients.

Methods

It is a randomized double-blind and placebo-controlled trial. A total of 48 patients with early type 2 DN were included as Euthyroid group, and 92 early type 2 DN with SCH were selected and randomly assigned to l-thyroxine treatment group (LT4 group) and placebo group (SCH group). Changes in urinary albumin excretion rate (UAER), serum malondialdehyde (MDA), superoxide dismutase (SOD) activity, urine 8-hydroxyl deoxyguanosine (8-OHdG), serum creatinine, estimated glomerular filtration rate, and lipid profile before and after 24 weeks of follow-up were examined and compared.

Results

The levels of UAER, MDA, 8-OHdG were higher, while the SOD activity was lower in DN patients with SCH than in DN patients (p < 0.05 for all). In the LT4 group, the levels of UAER, MDA, 8-OHdG decreased significantly (p < 0.05) to levels no longer different from the Euthyroid group. The SOD activity increased significantly. But in SCH group, the levels of mAlb, MDA, 8-OHdG were greater after 24 weeks of follow-up and greater than patients in the Euthyroid group. SOD activity decreased significantly after 24 weeks in the SCH group (p < 0.05).

Conclusion

Oxidative stress is greater in the DN patients with SCH, and SCH may exacerbate kidney injury in early DN patients. The LT4 treatment may decrease the oxidative stress and attenuate renal injury in DN patient with SCH.

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Authors and Affiliations

  1. Department of Nephropathy, Xianning Central Hospital, The First Affiliated Hospital of Hubei University of Science and Technology, 228 Jingui Road, Xianning, 437100, China

    Yong Chen

  2. Department of Medicine, School of Clinical Medicine Sciences, Hubei University of science and Technology, 88 Xianning Road, Xianning, 437100, China

    Ganlin Wu

  3. Department of Medicine, The Second Affiliated Hospital of Hubei University of Science and Technology, 58 Chahua Road, Xianning, 437100, China

    Meirong Xu

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  2. Ganlin Wu
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Correspondence to Ganlin Wu.

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Ethic approval

This research was approved by the ethics committee of the Xian’ning Central Hospital, The First Affiliated Hospital of Hubei University Of Science And Technology (No. XNLL-2014001) on March 17, 2014, and performed with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Chen, Y., Wu, G. & Xu, M. The effect of l-thyroxine substitution on oxidative stress in early-stage diabetic nephropathy patients with subclinical hypothyroidism: a randomized double-blind and placebo-controlled study. Int Urol Nephrol 50, 97–103 (2018). https://doi.org/10.1007/s11255-017-1756-y

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