Skip Navigation
Skip to contents

Diabetes Metab J : Diabetes & Metabolism Journal

Search
OPEN ACCESS

Articles

Page Path
HOME > Diabetes Metab J > Volume 38(1); 2014 > Article
Response
Response: Subclinical Hypothyroidism Is Independently Associated with Microalbuminuria in a Cohort of Prediabetic Egyptian Adults (Diabetes Metab J 2013;37:450-7)
Mervat M. El-Eshmawy1, Hala A. Abd El-Hafez1, Walaa Othman El Shabrawy2, Ibrahim A. Abdel Aal2
Diabetes & Metabolism Journal 2014;38(1):85-86.
DOI: https://doi.org/10.4093/dmj.2014.38.1.85
Published online: February 19, 2014
  • 3,165 Views
  • 41 Download
  • 2 Web of Science
  • 3 Crossref
  • 2 Scopus

1Department of Internal Medicine, Specialized Medical Hospital, Mansoura University Faculty of Medicine, Mansoura, Egypt.

2Department of Clinical Pathology, Specialized Medical Hospital, Mansoura University Faculty of Medicine, Mansoura, Egypt.

corresp_icon Corresponding author: Mervat M. El-Eshmawy. Department of Internal Medicine, Specialized Medical Hospital, Mansoura University Faculty of Medicine, Elgomhoria St., Mansoura 35516, Egypt. mervat2040@yahoo.com

Copyright © 2014 Korean Diabetes Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

prev
We sincerely appreciate the interest and comments regarding our study, "Subclinical hypothyroidism is independently associated with microalbuminuria in a cohort of prediabetic Egyptian adults" which was published in Diabetes & Metabolism Journal 2013;37:450-7.
Our responses to Dr. In-Kyung Jeong's comments follow:
First, in our study, thyroid stimulating hormone (TSH) was significantly associated with insulin resistance and fasting insulin whereas, there was no significant association between the level of TSH and hemoglobin A1c (HbA1c). This can be explained by: Both subclinical hypothyroidism (SCH) and prediabetes are associated with insulin resistance. Moreover, patients with SCH have insulin resistance that is comparable with that of the patients with hypothyroidism [1], so it is expected that insulin resistance to be correlated with TSH; however A1c still in the prediabetic range (relatively narrow and low range) which can explain such insignificant association.
About the study done by Billiac-Komarica et al. [2] the study group was different as a number of the study group was diabetic and the others were impaired glucose tolerance.
Secondly, we know that hypothyroidism patients has usually anemia which leads to falsely elevated HbA1c and also SCH can result in anemia (in lower percentages). As we did not depend on A1c in the diagnosis of prediabetes (World Health Organization criteria, 2006) [3], so we actually did not evaluate for anemia in this study population; the main aim was evaluation of the possible association between SCH and microalbuminuria among a cohort of Egyptian adults with prediabetes.
Thirdly, we agree with you about that the main cause of SCH in type 1 diabetes is autoimmune thyroiditis, about measurement of thyroid auto-antibody; actually we had limited resources to measure thyroid autoimmune antibodies for such large size study population. Anyhow this is one of our limitations and we would warrant recommending further studies to investigate this issue.
Fourthly, we agree with you about further prospective studies are needed to confirm the clear association in multiple ethnic groups and large prospective studies to clarify the contradictory results as regard the association between SCH and diabetic microvascular complication.
Thank you for taking interest in this study and for your thoughtful comments.

No potential conflict of interest relevant to this article was reported.

  • 1. Maratou E, Hadjidakis DJ, Kollias A, Tsegka K, Peppa M, Alevizaki M, Mitrou P, Lambadiari V, Boutati E, Nikzas D, Tountas N, Economopoulos T, Raptis SA, Dimitriadis G. Studies of insulin resistance in patients with clinical and subclinical hypothyroidism. Eur J Endocrinol 2009;160:785-790. ArticlePubMed
  • 2. Bilic-Komarica E, Beciragic A, Junuzovic D. Effects of treatment with L-thyroxin on glucose regulation in patients with subclinical hypothyroidism. Med Arh 2012;66:364-368. Article
  • 3. World Health Organization. International Diabetes Foundation. Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia: report of a WHO/IDF consultation. Geneva: World Health Organization; 2006.

Figure & Data

References

    Citations

    Citations to this article as recorded by  
    • ЦУКРОВИЙ ДІАБЕТ 2 ТИПУ ТА ЗАХВОРЮВАННЯ ЩИТОПОДІБНОЇ ЗАЛОЗИ: ПОШУК СПІЛЬНИХ МЕХАНІЗМІВ
      V. A. Musiienko, M. I. Marushchak
      Вісник медичних і біологічних досліджень.2020; (1): 74.     CrossRef
    • Association between thyroid function and diabetic nephropathy in euthyroid subjects with type 2 diabetes mellitus: a cross-sectional study in China
      Jian Wang, Huiqin Li, Mingjuan Tan, Gu Gao, Ying Zhang, Bo Ding, Xiaofei Su, Xiaocen Kong, Jianhua Ma
      Oncotarget.2019; 10(2): 88.     CrossRef
    • Poor glycemic control is associated with the risk of subclinical hypothyroidism in patients with type 2 diabetes mellitus
      Jae Ho Cho, Ho Jin Kim, Jun Ho Lee, Il Rae Park, Jun Sung Moon, Ji Sung Yoon, In-Kyu Lee, Kyu Chang Won, Hyoung Woo Lee
      The Korean Journal of Internal Medicine.2016; 31(4): 703.     CrossRef

    • PubReader PubReader
    • Cite this Article
      Cite this Article
      export Copy Download
      Close
      Download Citation
      Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

      Format:
      • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
      • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
      Include:
      • Citation for the content below
      Response: Subclinical Hypothyroidism Is Independently Associated with Microalbuminuria in a Cohort of Prediabetic Egyptian Adults (Diabetes Metab J 2013;37:450-7)
      Diabetes Metab J. 2014;38(1):85-86.   Published online February 19, 2014
      Close
    • XML DownloadXML Download
    Response: Subclinical Hypothyroidism Is Independently Associated with Microalbuminuria in a Cohort of Prediabetic Egyptian Adults (Diabetes Metab J 2013;37:450-7)
    Response: Subclinical Hypothyroidism Is Independently Associated with Microalbuminuria in a Cohort of Prediabetic Egyptian Adults (Diabetes Metab J 2013;37:450-7)
    El-Eshmawy MM, Abd El-Hafez HA, El Shabrawy WO, Abdel Aal IA. Response: Subclinical Hypothyroidism Is Independently Associated with Microalbuminuria in a Cohort of Prediabetic Egyptian Adults (Diabetes Metab J 2013;37:450-7). Diabetes Metab J. 2014;38(1):85-86.
    DOI: https://doi.org/10.4093/dmj.2014.38.1.85.

    Diabetes Metab J : Diabetes & Metabolism Journal
    Close layer
    TOP