Endocrine Abstracts

The aim was to assess iodine status and thyroid structure changes in a cohort of patients with diabetes mellitus type 1 (DM1) at different stages of comorbid chronic kidney disease (CKD) after achievement of adequate iodine status in Belarus. We examined 62 patients (20m; 42f; age 42.1±12.07 years; BMI 26.14±5.27 kg/m²; duration of DM1 22.9±8.67 years; age at DM1 onset 19.89±12.72 years) at CKD stages 1, 2, 3, 5 (n=28; 21; 12; 1 respectively). Urinary iodine excretion (UIE) in urine morning sample (UMS) was measured with the use of cerium–arsenite method approved WHO as a standard. Iodine deficiency (ID) is defined as a median urinary iodine concentration <50 μ/l in a population. All data concerning ultrasound structure of thyroid gland (ThG) were determined as normal, reduced, increased volume (NVol, redVol, incrVol), homogeneity (hypo-, hyper-, homogeneous), local pathology (abs, single, multiple). In the examined group evaluating iodine supplementation in UMS lack of ID was registered – a median UIE at the time of survey was 115.5 mkg/l. Comparative analysis of patients in the subgroups according to CKD stages revealed reliable differences in level of UIE (P=0.0133), total volume of ThG (P=0.0325),and in homogeneity (P=0.040).UIE in UMS correlates with urea plasma level (r=−0.309), GFR (r=0.420), CKD stage (r=−0.323). Total volume of ThG correlates with plasma urea (r=0.313) and creatinine levels (r=0.259). Strong correlation was revealed between homogeneity and age at DM1 onset (r=0.292). According to the ultrasound study of patients an incrVol was detected only in two patients (3.23%), in 33 revealed NVol (53.22%) and redVol in 27 patients (43.55%). Structural changes in ThG such as hypoechoic structure were reported in 24 patients (38.71%). Single and multiple pathology was recorded in 16 and seven patients respectively (25.81 and 11.29%). ID was not registered in examined population of patients that demonstrates the effectiveness of iodine prophylaxis. Revealed a direct correlation between level of UIE and CKD stage can lead to a variety of structural changes in ThG which requires close monitoring of patients with reduced renal function.