EPIDEMIOLOGICAL ASPECTS OF COMORBID PATHOLOGY – DIABETES MELLITUS AND HYPOTHYROIDISM

Aim. Determination of the prevalence of functional disorders of thyroid in patients with type 1 and type 2 diabetes mellitus (DM), study of the gender- and age-related characteristics of the combination of type 1 and type 2 DM with primary hypothyroidism (PH). Material and Methods. 157 Patients with type 1 and type 2 DM were examined. Of these, the 1st group included 52 people with type 1 DM (32 females and 20 males) of the average age 31.5 [23.5; 46.5] years, the 2nd group included 105 people with type 2 DM (75 females and 30 males) of the average age 60.0 [54.0;65.0] years. The following examinations were conducted: anthropometric examination, determination of HbA1c, of the level of thyrotropic hormone (TTH), free thyroxin (fT4), free triiodothyronine (fT3), and ultrasound examination of the thyroid gland. Results. The prevalence of clinical hypothyroidism in patients with type 1 DM was 25.0%, with type 2 DM – 16.19%; of subclinical hypothyroidism – 7.69 and 9.52%, respectively. The level of TTH in the 1st group was: in patients with type 1 DM – 1.67 [1.35;2.21] mIU/l, when combined with PH – 3.55 [1.65;12.2] mIU/l (p=0.0166); in the 2nd group – 1.65 [1.24;2.6] and 6.75 [3.8; 12.0] mIU/l (p=0.000002), respectively. The prevalence of thyroid pathology in females was significantly higher than in males. Females with type 1 DM were under 4.7 times higher risk, and those with type 2 DM under twice higher risk of development of clinical hypothyroidism than males: OR=4.714 (Cl 1.921-24.131) and OR=2.066 (Cl 1.548-7.784), respectively. 52.2% Of patients with DM and PH had positive heredity – OR=2.503 (CI 1.228-5.105). An increased level of HbA1c was found in groups of patients with type 1 and type 2 DM with comorbid pathology. Conclusion. Thyroid pathology has a wide prevalence in the population of patients with type 1 and type 2 diabetes mellitus. Risk factors for the development of primary hypothyroidism are female gender and positive heredity. The presence of comorbid hypothyroidism produces a negative effect on carbohydrate metabolism. Identification of the epidemiological features of comorbid pathology helps optimize recommendations for screening for primary hypothyroidism in adult patients with diabetic mellitus.