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Does autoimmune hypothyroidism increase the risk of neurovascular complications in type 1 diabetes?

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Abstract

Background

Type 1 diabetes (T1DM) often coexists with other autoimmune diseases, most commonly with hypothyroidism. To date, the influence of coexisting autoimmune hypothyroidism (AHT) on the course of chronic neurovascular complications of autoimmune diabetes has not been established. The aim of the study was to assess the relationship between AHT and the occurrence of chronic T1DM complications.

Methods

The study group comprised 332 European Caucasian participants with T1DM [165 (49.7%) men]. AHT was recognized in subclinical and overt hypothyroidism and confirmed by the presence of anti-thyroid autoantibodies: anti-peroxidase (ATPO) and/or anti-thyroglobulin (ATg) and ultrasonography (hypoechogenicity, parenchymal heterogeneity, lymph nodes assessment).

Results

In the analyzed group, 48.5% of patients were diagnosed with at least one neurovascular complication. At the time of enrollment, 16.3% of participants were diagnosed with AHT. Patients with AHT, compared to those without AHT, were characterized by a higher prevalence of neurovascular complications (64.8 vs. 45.3%; P = 0.009) and retinopathy (55.6 vs. 38.9%; P = 0.02). There were significant differences between groups with and without neurovascular complications, with regard to classic risk factors for chronic diabetes complications: age, T1DM duration, SBP, DBP, HbA1c, TG, eGFR and hypertension prevalence. In the multivariate logistic regression analysis, AHT was an independent predictor of neurovascular complications after adjusting for age, DBP, HbA1c and TG (odds ratio, 2.40; 95% confidence interval, 1.17–4.92; P = 0.02).

Conclusions

AHT coexisting with T1DM was associated with a higher incidence of neurovascular complications.

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Acknowledgements

We thank Malgorzta Grzelka and Jaroslaw Opiela for language revision of this article.

Funding

This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.

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Authors and Affiliations

Authors

Contributions

ARF and BF planned and designed the study. AGW, AU, AA conducted data acquisition. BF performed the statistical analysis. ARF and BF wrote the manuscript. AGW, AU, AA, DZZ revised the manuscript. All authors approved the submitted version.

Corresponding author

Correspondence to B. Falkowski.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance to the ethical standards of the institutional and/or national research committee (The Bioethical Committee of Poznan University of Medical Sciences; reference numbers: 539/12 and 465/15) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Each enrolled subject delivered a written informed consent for participation in the study.

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Rogowicz-Frontczak, A., Falkowski, B., Grzelka-Wozniak, A. et al. Does autoimmune hypothyroidism increase the risk of neurovascular complications in type 1 diabetes?. J Endocrinol Invest 43, 833–839 (2020). https://doi.org/10.1007/s40618-019-01171-x

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  • DOI: https://doi.org/10.1007/s40618-019-01171-x

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