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Efectos del hipotiroidismo subclínico en la nefropatía que complica la diabetes tipo 2: el estudio de Fremantle sobre
S A Paul Chubb1, Wendy A Davis1, Timothy M E Davis1,2
1Medical School, University of Western Australia, Fremantle Hospital, Fremantle, Western Australia, Australia.
The Journal of clinical endocrinology and metabolism
|August 29, 2025
Resumen
El hipotiroidismo subclínico persistente (SCH) en la diabetes tipo 2 está relacionado con un aumento de la albuminuria, lo que indica una posible disfunción renal. La evaluación temprana de la tiroides puede ser beneficiosa para el tratamiento de la enfermedad renal diabética.
Área de la Ciencia:
- Endocrinología
- Nefrología
- Investigación de la diabetes
Sus antecedentes:
- El papel del hipotiroidismo subclínico (SCH) en la progresión de la disfunción renal intrínseca entre las personas con diabetes mellitus tipo 2 (DMT2) no está claro.
- Comprender esta asociación es crucial para la detección temprana y el tratamiento de la enfermedad renal diabética.
Objetivo del estudio:
- Determinar si la SCH persistente durante un período de 4 años está asociada con el desarrollo de insuficiencia renal en pacientes con DM2.
- Investigar el impacto de la disfunción tiroidea sostenida en los marcadores de salud renal en una población diabética.
Principales métodos:
- Se realizó un estudio longitudinal de observación en una población urbana de individuos con DM2.
- Los participantes (n=725) sin disfunción tiroidea previa fueron seguidos durante aproximadamente 4,3 años.
- Se analizaron los cambios en la tasa de filtración glomerular estimada (eGFR) y la relación albúmina: creatinina en orina (ACR), estratificando a los participantes según el estado de la tiroides (eutiroidismo, hipotiroidismo SCH/overt transitorio, hipotiroidismo SCH/overt persistente).
Principales resultados:
- No se observaron cambios significativos en el eGFR en ningún grupo de estado tiroideo.
- Los participantes con hipotiroidismo SCH/overt persistente mostraron un aumento significativo en el ACR (22,0 ± 81,4 mg/ mmol), lo que indica un aumento de la albuminuria.
- Este aumento de la ACR no se observó en los grupos de eutiroidismo o SCH transitorio/ hipotiroidismo evidente, lo que sugiere una relación específica entre la SCH persistente y la albuminuria.
Conclusiones:
- La SCH persistente en individuos con DM2 está asociada con albuminuria incidente, un marcador de daño renal.
- Estos hallazgos sugieren que puede ser necesaria una evaluación regular de la función tiroidea en pacientes con DM2.
- La terapia de reemplazo de tiroxina podría mejorar la albuminuria en individuos afectados, lo que justifica una investigación adicional.
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