AUTHOR=Zhang Shaojun , Feng Guilong , Kang Fangfang , Guo Yali , Ti Hongyan , Hao Lufang , Gao Peng , Gao Jiangqin 

TITLE=Hypothyroidism and Adverse Endpoints in Diabetic Patients: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Endocrinology

VOLUME=10

YEAR=2020

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2019.00889

DOI=10.3389/fendo.2019.00889

ISSN=1664-2392

ABSTRACT=<p><bold>Background:</bold> This study investigated the relationship strength between hypothyroidism and cardiovascular and renal outcomes in diabetic patients.</p><p><bold>Methods:</bold> The electronic databases PubMed, EmBase, and Cochrane library were screened for relevant studies published before November 2018. The outcomes included major cardiovascular events (MACEs), all-cause mortality, cardiac death, stroke, diabetic nephropathy (DN), diabetic retinopathy (DR), and chronic kidney disease (CKD). The pooled results for all outcomes were calculated using random-effects models.</p><p><bold>Results:</bold> A total of eight studies met the inclusion criteria. The summary results indicated that hypothyroidism was not associated with the risk of MACEs (OR:1.21; 95%CI:0.68–2.16; <italic>P</italic> = 0.514), all-cause mortality (OR:1.27; 95%CI:0.93–1.74; <italic>P</italic> = 0.136), cardiac death (OR:1.16; 95%CI:0.89–1.52; <italic>P</italic> = 0.271), stroke (OR:0.96; 95%CI: 0.49–1.88; <italic>P</italic> = 0.915), and DN (OR:1.71; 95%CI:0.37–7.90; <italic>P</italic> = 0.490). There was a significant association between hypothyroidism and the risk of DR (OR:1.73; 95%CI:1.08–2.77; <italic>P</italic> = 0.023) and CKD (OR:1.22; 95%CI:1.10–1.36; <italic>P</italic> &lt; 0.001).</p><p><bold>Conclusions:</bold> These findings indicate that diabetic patients with hypothyroidism have an increased risk of DR and CKD. Additional large-scale prospective studies should be carried out to verify the prognosis of patients with diabetes and hypothyroidism.</p>