Association between decreased thyroid stimulating hormone and hyperuricemia in type 2 diabetic patients with early-stage diabetic kidney disease

Background: Serum uric acid (SUA) is associated with the development of diabetic kidney disease (DKD). Thyroid hormones can regulate metabolism and insulin resistance. The relationship between SUA and thyroid function in patients with DKD is still uncertain. In current study, we aimed to investigate the association between thyroid stimulating hormone (TSH) and SUA in type 2 diabetic patients with early-stage DKD. Methods: Two hundred fifty-four type 2 diabetic patients with early-stage DKD were enrolled in current study and were further classified as high SUA group (SUA level > 420 mu mol/L in males or > 360 mu mol/L in females, n = 101) and normal SUA group (SUA level <= 420 mu mol/L in males or <= 360 mu mol/L in females, n = 153). Eighty-five control subjects were recruited as control group. The clinical characteristics were obtained via face-to-face surveys and medical records. Results: Compared with normal SUA group and control group, high SUA group exhibited the increased SUA level, and the decreased TSH level (P < 0.017 for all), and no significant difference was detected in SUA and TSH between normal SUA group and control group. TSH was negatively associated with SUA (r = - 0.35, P < 0.001) in type 2 diabetic participants with early-stage DKD. Furthermore, the decreased TSH level was independently correlated with higher SUA level (beta = - 25.69, P < 0.001), and retained a significant association with hyperuricemia (odds ratio = 1.73, P = 0.002) after adjusting for confounding factors in type 2 diabetic patients with early-stage DKD. Conclusions: TSH is negatively correlated with SUA, and decreased TSH is an independent risk factor for hyperuricemia in type 2 diabetic patients with early-stage DKD. These results indicate that thyroid hormones, TSH in particular, might participate in regulating uric acid metabolism in patients with early-stage DKD.

Automated summary

This study found that in type 2 diabetic patients with early-stage DKD, a decreased TSH level is negatively correlated with an increase in SUA, and independently associated with higher SUA levels, as well as significantly linked to hyperuricemia after adjusting for confounding factors. These findings suggest that thyroid hormones, especially TSH, may play a role in regulating uric acid metabolism in patients with early-stage DKD.