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"Latar Belakang: Beberapa penelitian terakhir menunjukkan adanya hubungan antara diabetes melitus tipe 2 (DMT2) dengan kejadian hipotiroid subklinis (HSK). Penelitian lain menunjukkan bahwa pada DMT2 yang disertai HSK, angka kejadian retinopati ternyata lebih tinggi dibanding pada DMT2 yang tanpa disertai HSK. Pasien HSK sendiri diketahui mempunyai risiko tinggi terhadap kejadian dislipidemia. Bagaimana hubungan antara dislipidemia dengan retinopati pada pasien DMT2 dengan HSK, sampai saat ini masih belum diketahui. Tujuan: Mengetahui proporsi HSK pada pasien DMT2, hubungan antara HSK dengan kontrol glukosa darah, HSK dengan dislipidemia, serta hubungan antara dislipidemia dengan kejadian retinopati pada pasien DMT2 dengan HSK. Metode: Desain penelitian yang digunakan adalah potong lintang. Sampel adalah pasien dewasa yang sudah didiagnosis DMT2 minimal 1 tahun, yang berobat ke poliklinik rawat jalan Divisi Metabolik Endokrin RSCM yang memenuhi kriteria inklusi. Data-data yang dikumpulkan adalah kontrol glukosa (HbA1c), profil lipid (kolesterol total, LDL, HDL, trigliserida), TSHs, fT4 dan data retinopati. Data diambil dari rekam medis maupun pemeriksaan laboratorium. Hasil: Proporsi penyakit HSK pada pasien DMT2 sebesar 7.2 % dan sebagian besar berusia di atas 60 tahun. Tidak didapatkan perbedaan proporsi antara lakilaki dan perempuan. Dari analisis didapatkan pasien DMT2 dengan kontrol gula darah yang buruk (HbA1c >7) memiliki risiko 3,664 kali lebih besar mengalami HSK dibanding dengan pasien DMT2 yang gula darahnya terkontrol baik (p:0,010). Pada pasien DMT2 dengan HSK yang disertai dislipidemia, risiko terkena retinopati 2,76 kali lebih besar dibanding pasien tanpa dislipidemia (p:0,014). Simpulan: Terdapat hubungan bermakna antara HSK dengan kontrol gula darah (HbA1c) pada pasien DMT2. Terdapat hubungan antara HSK dan dislipidemia pada pasien DMT2. Terdapat hubungan antara dislipidemia dengan kejadian retinopati pada pasien DMT2 dengan HSK.

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Background: Some recent studies suggest that there is a link between type 2 diabetes mellitus (T2DM) and the incidence of subclinical hypothyroid (SCH). Other studies have shown that if a T2DM is accompanied SCH, the incidence of retinopathy was higher than in the T2DM without SCH. SCH patients themselves are known to have a high risk of occurrence of dyslipidemia. The the relationship between the incidence of dyslipidemia and retinopathy in patients with T2DM with SCH, is still unknown.

Objective: To determine the proportion of SCH in patients with T2DM, the relationship between SCH and glycemic control (HbA1c), SCH with dyslipidemia, and dyslipidemia with the incidence of retinopathy in T2DM patients with SCH.

Methods: The study design used is cross sectional. Sample were adult patients who have been diagnosed with T2DM at least 1 year, who went to the outpatient ward of Metabolic Endocrine Division, Cipto Mangunkusumo Hospital. Collected data include glycemic control (HbA1c), lipid profile (total cholesterol, LDL, HDL, triglycerides), TSHs, FT4 and retinopathy data. Data were retrieved from medical records and laboratory tests.

Results: The proportion of SCH in patients with T2DM 7.2%, and mostly aged over 60 years. There were no differences in the proportion between men and women. From the analysis reveals the T2DM patients with poor blood sugar control (HbA1c >7) had 3.664 times greater risk of developing SCH compared with T2DM patients with well-controlled blood sugar (p:0.010). In patients with T2DM with SCH accompanied dyslipidemia, retinopathy risk 2.76 times greater than patients without dyslipidemia (p:0.014).

Conclusion: There is a significant relationship between the SCH and glycemic control in patients with T2DM, SCH and dyslipidemia and also between dyslipidemia and retinopathy in T2DM patients with HSK."

"ABSTRACTBackground: hypothyroidism is a common concomitant disease of non-alcoholic fatty liver disease (NAFLD). Previous studies regarding the relationship between subclinical hypothyroidism and NAFLD showed conflicting results, ranging from a strong association to not significant one. This case report aimed to investigate the risk of developing NAFLD in subclinical hypothyroidism patients. Methods: literature searching used ScienceDirect, PubMed, ProQuest, and Scopus. Filtering process of titles and abstracts by using inclusion and exclusion criteria yielded 4 eligible articles (1 systematic review, 1 prospective cohort, 1 retrospective cohort, and 1 case-control study) for answering the clinical question. Critical appraisal was conducted by using worksheets from Centre for Evidence-Based Medicine, University of Oxford. Results: the systematic review was considered invalid due to its less comprehensive search for relevant studies, inappropriate article selection to find a causal relationship between diseases, and statistical heterogeneity. The retrospective cohort was decided unimportant because it possessed a relative risk of 0.85 (95% confidence interval [CI], 0.72--1.00) which the upper limit of its CI included 1.00. The rest were valid and had important risk relative and odds ratio (1.27 [95% CI, 1.09--1.47], 3.41 [95% CI, 1.16--9.98]; respectively). The number needed to harm (5 - 17) indicated the clinically meaningful harm of the exposure since only a few patients with subclinical hypothyroidism is needed to obtain one additional NAFLD incidence. Those two articles were also suitable to be applied in our case. Conclusion: patients with subclinical hypothyroidism, compared to euthyroid patients, are at higher risk of developing NAFLD."