Sailesh, S., Randeva, Harpal S., Callaghan, C. J. O., O'Hare, J. Paul, Philip, Sam, Saravanan, Ponnusamy and Patel, Vinod (2018) The THOR effect : thyroid hormone offsets retinopathy. Journal of Endocrinology and Thyroid Research, 3 (1). 555605. ISSN 2573-2188.
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Abstract
Objective
Thyroid status has been implicated in macrovascular disease both in patients with and without diabetes, however its effect on microvascular complications has not been explored. We assessed the prevalence and time to development of diabetic retinopathy in patients with type 2 diabetes with and without thyroxine treatment.
Research design and methods
The prevalence of retinopathy was determined, in a retrospective cohort study from a secondary care referral diabetes clinic patients with type 2 diabetes and coexisting treated hypothyroidism (THD; n=147) and duration matched controls without hypothyroidism (DM2; n=383). Using Kaplan-Meier survival analysis and Cox Proportional Hazards regression model we estimated the time to development of retinopathy in the two groups.
Results
Prevalence of retinopathy was 27.9% in THD group, as compared to 55.1% in the DM2 group (p<0.001). THD were less than one- third as likely to have concurrent retinopathy than, DM2 patients (OR=0.32; 95% CI=0.21 to 0.48; p<0.001). There was a significant difference in the median time to retinopathy between THD and DM2 patients (21.0yrs vs. 13.0yrs: Log-Rank p<0.001). Risk of developing retinopathy in THD patients was two-fifths of that of DM2 patients (hazard ratio=0.418; p<0.001) in a time-dependent variable analysis. The risk of developing retinopathy was concomitantly lower for patients with longer duration of hypothyroidism and thyroxine treatment prior to diagnosis of diabetes (Hazard ratio=0.957:p= 0.004).
Conclusion
A significant sparing effect on development of retinopathy was noted in type 2 diabetic patients with concomitant hypothyroidism (on thyroxine). The exact mechanism(s) for these observations remain to be elucidated.
| Item Type: | Journal Article |
|---|---|
| Alternative Title: | |
| Subjects: | R Medicine > RE Ophthalmology |
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
| Library of Congress Subject Headings (LCSH): | Diabetic retinopathy, Diabetes -- Complications, Retina -- Diseases , Non-insulin-dependent diabetes, Thyroid gland |
| Journal or Publication Title: | Journal of Endocrinology and Thyroid Research |
| Publisher: | Juniper Publishing Group |
| ISSN: | 2573-2188 |
| Official Date: | 20 February 2018 |
| Dates: | Date Event 20 February 2018 Published 3 February 2018 Accepted |
| Volume: | 3 |
| Number: | 1 |
| Article Number: | 555605 |
| Status: | Peer Reviewed |
| Publication Status: | Published |
| Access rights to Published version: | Restricted or Subscription Access |
| Date of first compliant deposit: | 4 June 2018 |
| Date of first compliant Open Access: | 5 June 2018 |
| RIOXX Funder/Project Grant: | Project/Grant ID RIOXX Funder Name Funder ID |
| Related URLs: | |
| URI: | https://wrap.warwick.ac.uk/102924/ |
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