Background and objective: Hypothyroidism is often associated with kidney diseases. The present retrospective study was conducted to find out the prevalence of hypothyroidism in patients with chronic renal failure and T2DM in Saudi community-based hospital.
Design: We analyzed retrospectively 1286 participants who are between the age of 20 to 96 years. All patients were from the population of the Primary health center at King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia. All data were collected on the basis of a review of electronic medical data. Participants were defined as having type 2 diabetes mellitus (T2DM) according to self-report, clinical reports, use of antidiabetic agents or HbA1c (≥6.5). All patients in the present study fulfilled the revised National Kidney Foundation criteria for the diagnosis of chronic renal failure (CRF). The total number of cohort were separated on basis of age values into four groups: <40 years, 40-49 years, 50-59 years and ≥60 years.
Results: 1286 subjects with T2DM were included, there were 346 cases (26.9 % ) male and 940 cases (73.1 %) were female with mean age 55.4 ±12.3. There were 66 cases (5.1 % ), 736 cases (57.2 % ) and 241 cases (18.7 % ) with CKD, HTN and hypothyroidism respectively. The mean HbA1c, TSH and FT4 value were 8.1±2.2, 3.7±7.2 mIU/l and 15.1±2.9 pmol/l respectively. Among cases of T2DM and CRF, there were 21 cases (38.1 %) with hypothyroidism, p=0.005. There was males predominance, 13 case 61.9% vs. 8 cases (38.1%) for females, p<0.0001. Regression analysis of odd ratio of risk factors for patients with T2DM and CRF showed that male gender, age, HTN, presence of hypothyroidism and HbA1c were associated with higher likely hood of CRF, (OR=5.4; 95% confidence interval [CI]=3.1, 9.4), p<0.0001) , (OR=1.1; 95% CI=1.03, 1.1), p<0.0001), (OR=3.1; 95% CI=1.5, 6.4), p=0.002), (OR=3.5; 95% CI=1.9, 5.4), p<0.0001) and (OR=1.2; 95% CI=1.1, 1.3), p=0.003) respectively. The prevalence of hypothyroidism in cases of T2DM and CRF was higher across all age groups and was more prevalent in the seventh decade (24.2% vs. 4.7%) compared to cases with no CRF.
Conclusion: We conclude that despite the limitations of this hospital-based retrospective study, hypothyroidism is highly prevalent in cohort of Saudis with CRF and T2DM. The majority of our patients in our finding were predominantly males. These two observations remain to be validated by population-based studies. In the absence of registry data, larger cooperative studies involving diverse population samples from multiple centers could help to provide further information on the true prevalence of hypothyroidism.
Hypothyroidism, Chronic renal failure, Type 2 Diabetes, Saudi Arabia