TYPE 2 DIABETES MELLITUS PATIENTS WITH CHRONIC KIDNEY DISEASE: RELATIONSHIP WITH THYROID DYSFUNCTION, OXIDATIVE STRESS, C-REACTIVE PROTEIN AND IL-6 IN PATIENTS ATTENDING A TERTIARY CARE HOSPITAL

Abstract

Background Type 2 diabetes mellitus (T2DM) is a major metabolic disorder associated with progressive renal impairment. Chronic kidney disease (CKD) in diabetic patients may be accompanied by thyroid dysfunction, increased oxidative stress, and chronic low-grade inflammation. Thyroid-stimulating hormone (TSH), free thyroid hormones, malondialdehyde (MDA), superoxide dismutase (SOD), C-reactive protein (CRP), and interleukin-6 (IL-6) may therefore provide useful information regarding the interaction between metabolic, renal, oxidative, and inflammatory abnormalities.
Aim To assess the relationship of thyroid dysfunction, oxidative stress, CRP, and IL-6 with CKD among patients with T2DM attending a tertiary care hospital.
Materials and Methods A cross-sectional study was designed involving 100 patients with T2DM. Based on renal parameters, including estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio, participants were categorized into 35 CKD-positive and 65 CKD-negative patients. Demographic and clinical characteristics were recorded. Blood samples were assessed for fasting blood glucose, HbA1c, serum urea, creatinine, TSH, free T3, free T4, MDA, SOD, glutathione, CRP, and IL-6. Urinary ACR and eGFR were also evaluated. Statistical comparisons and correlation analysis were performed.
Results CKD-positive patients had significantly higher serum urea, creatinine, urinary ACR, and HbA1c and significantly lower eGFR than CKD-negative patients. Thyroid abnormalities were more frequent among CKD-positive patients, with higher TSH and lower free T3 and free T4 levels. Thyroid dysfunction was observed in 12 (34.3%) CKD-positive patients compared with 8 (12.3%) CKD-negative patients. MDA was significantly increased, whereas SOD and glutathione were reduced in the CKD group. Inflammatory markers were also significantly elevated, with higher CRP and IL-6 concentrations among CKD-positive patients. eGFR showed negative correlations with TSH, MDA, CRP, and IL-6 and positive correlations with free T3 and SOD.
Conclusion Among patients with T2DM, CKD was associated with thyroid dysfunction, increased oxidative stress, impaired antioxidant defense, and enhanced systemic inflammation. The observed associations between eGFR and TSH, MDA, CRP, and IL-6 suggest that declining renal function may occur alongside abnormalities in thyroid, oxidative, and inflammatory pathways. Further prospective studies involving larger populations are required to establish the temporal and causal relationships between these parameters.