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Hadgu R, Worede A, Ambachew S. Prevalence of thyroid dysfunction and associated factors among adult type 2 diabetes mellitus patients, 2000-2022: a systematic review and meta-analysis. Syst Rev 2024; 13:119. [PMID: 38689302 PMCID: PMC11061916 DOI: 10.1186/s13643-024-02527-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 04/12/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Thyroid dysfunction (TD) and type 2 diabetes mellitus (T2DM) frequently co-occur and have overlapping pathologies, and their risk increases with age. Thyroid dysfunction along with T2DM will worsen macro- and microvascular complications, morbidity, and mortality. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guideline was followed. The databases used were Embase, ScienceDirect, PubMed, and Google Scholar. The Joana Briggs Institute (JBI) scale was used to assess the quality of the included studies. The data was extracted by Microsoft Excel and analyzed through STATA version 14 software. The overall pooled prevalence of TD and its main components were estimated using the random-effects model. The consistency of studies was assessed by I2 test statistics. Pooled meta-logistic regression was used to present the pooled prevalence with a 95% confidence interval (CI). Besides, subgroup and sensitivity analyses were employed. RESULT Thirty-eight studies were included. The pooled prevalence of TD was 20.24% (95% CI: 17.85, 22.64). The pooled prevalence of subclinical hypothyroidism, hypothyroidism, subclinical hyperthyroidism, and hyperthyroidism was found to be 11.87% (95% CI: 6.90, 16.84), 7.75% (95% CI: 5.71, 9.79), 2.49% (95% CI: 0.73, 4.25), and 2.51% (95% CI: 1.89, 3.13), respectively. Subgroup analysis based on continent revealed a higher prevalence of TD in Asia and Africa. Factors like being female, HbA1c ≥ 7%, DM duration > 5 years, family history of TD, central obesity, smoking, the presence of retinopathy, and neuropathy were found associated with TD. CONCLUSION The current systematic review and meta-analysis showed that the TD's pooled prevalence was relatively higher than the general population. Therefore, regular screening of TD should be done for T2DM patients.
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Affiliation(s)
- Rishan Hadgu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, P.O. Box 21, Arba Minch, Ethiopia.
| | - Abebaw Worede
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Sintayehu Ambachew
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
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Sakyi SA, Ameyaw B, Laing EF, Anthony R, Ephraim RKD, Effah A, Kwayie AA, Senu E, Anto EO, Acheampong E, Afranie BO, Amoani B, Opoku S. Thyroid dysfunction and glycaemic control among Type 2 diabetes mellitus patients in Ghana: A comparative cross-sectional study. Endocrinol Diabetes Metab 2023; 6:e447. [PMID: 37621219 PMCID: PMC10638622 DOI: 10.1002/edm2.447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/06/2023] [Accepted: 08/12/2023] [Indexed: 08/26/2023] Open
Abstract
INTRODUCTION Thyroid disorders and diabetes mellitus coexist and are prevalent endocrinopathies among adult population. Thyroid dysfunction contributes to metabolic imbalances, increase beta-cell apoptosis and glucose intolerance. There is paucity of data and contradicting findings on how thyroid dysfunction influence glycaemic control. Therefore, we evaluated thyroid dysfunction and glycaemic control among Type 2 diabetes mellitus (T2DM) patients in Ghana. METHODS A comparative cross-sectional study was conducted among 192 T2DM patients from Effia Nkwanta Regional Hospital. Three consecutive monthly fasting plasma glucose (FBG) and glycated haemoglobin (HbA1c) were analysed and the results were classified as, moderate hyperglycaemia (MH) (FBG = 6.1-12.0 mmol/L, HbA1c < 7%), severe hyperglycaemia (SH) (FBG ≥ 12.1 mmol/L, HbA1c > 7%) and good glycaemic controls (GC) (FBG = 4.1-6.0 mmol/L, HbA1c < 7%). Thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4), body mass index (BMI) and other clinical parameters were measured. Data analysis was done using R language version 4.0.2 and p < .05 was considered statistically significant. RESULTS There were no significant differences in age (years) between patients in the various glycaemic groups (p = .9053). The overall prevalence of thyroid disorders was 7.8% among T2DM patients. The prevalence of thyroid disorders was higher in patients with SH (11.7%) followed by those with MH (7.5%) and then those with GC (5.4%). Serum levels of TSH and FT3/FT4 ratio were significantly lower in T2DM patients with SH compared to those with MH and the GC (p < .0001). However, FT4 was significantly higher in SH patients compared to the good glycaemic controls (p < .01). The first tertiles of TSH [aOR = 10.51, 95% CI (4.04-17.36), p < .0001] and FT3 [aOR = 2.77, 95% CI (1.11-6.92), p = .0290] were significantly and independently associated with increased odds of hyperglycaemia. CONCLUSION The prevalence of thyroid dysfunction is high in T2DM and increases with hyperglycaemia. Reduced TSH and T3 may worsen glycaemic control. Periodic monitoring of thyroid function should be incorporated into management guidelines among T2DM patients in Ghana.
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Affiliation(s)
- Samuel Asamoah Sakyi
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Bright Ameyaw
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
- Laboratory DepartmentEffia Nkwanta Regional HospitalWestern RegionGhana
| | - Edwin Ferguson Laing
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Richard Anthony
- Department of Internal MedicineEffia Nkwanta Regional HospitalWestern RegionGhana
| | | | - Alfred Effah
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Afia Agyapomaa Kwayie
- Department of Medical Diagnostics, Faculty of Allied Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Ebenezer Senu
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Enoch Odame Anto
- School of Medical and Health ScienceEdith Cowan UniversityJoondalupAustralia
| | - Emmanuel Acheampong
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
- School of Medical and Health ScienceEdith Cowan UniversityJoondalupAustralia
| | - Bright Oppong Afranie
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Benjamin Amoani
- Department of Medical Laboratory TechnologyUniversity of Cape CoastCape CoastGhana
| | - Stephen Opoku
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
- Department of Medical Diagnostics, Faculty of Allied Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
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Kim H, Jung DY, Lee S, Cho J, Yim HW, Kim H. Retrospective cohort analysis comparing changes in blood glucose level and body composition according to changes in thyroid-stimulating hormone level. J Diabetes 2022; 14:620-629. [PMID: 36114679 PMCID: PMC9512769 DOI: 10.1111/1753-0407.13315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/08/2022] [Accepted: 08/27/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND In the euthyroid state, the risk of developing diabetes according to changes in thyroid-stimulating hormone (TSH) levels remains controversial. Additionally, the correlation of various body indices affecting blood glucose levels according to changes in TSH levels over a certain period is not well known. METHODS Patients who underwent health check-ups twice at a 2 year interval at a tertiary university hospital between 2009 and 2018 were included. By dividing baseline TSH levels into quartiles (TSH_Q1, Q2, Q3, and Q4), various variables were compared, and their changes after 2 years (∆TSH_Q1, Q2, Q3, and Q4) were confirmed. RESULTS Among 15 557 patients, the incidence of diabetes mellitus after 2 years was 2.4% (377/15 557 patients). There was no statistically significant difference in the incidence of diabetes according to TSH_Q (p = 0.243) or ∆TSH_Q (p = 0.131). However, as TSH levels increased, skeletal muscle mass decreased (p < 0.001), and body fat mass and percent body fat significantly increased (p < 0.001). As ∆TSH increased, ∆fasting blood glucose and ∆body mass index also significantly increased (all p < 0.001). The incidence of diabetes decreased significantly as skeletal muscle mass increased (odds ratio 0.734, p < 0.001). CONCLUSIONS Owing to the short study period, it was not possible to prove a statistical relationship between the incidence of diabetes mellitus and TSH levels in the euthyroid state. Significant decreases in skeletal muscle mass and increases in body mass index and body fat mass according to baseline TSH levels were demonstrated. Therefore, a focus on improving physical functions, such as increasing muscle mass and decreasing fat, is required in this case.
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Affiliation(s)
- Hyunah Kim
- College of PharmacySookmyung Women's UniversitySeoulRepublic of Korea
| | - Da Young Jung
- Department of Biostatistics, Clinical Research Coordinating Center, Catholic Medical CenterThe Catholic University of KoreaSeoulRepublic of Korea
| | - Seung‐Hwan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
| | - Jae‐Hyoung Cho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
| | - Hyeon Woo Yim
- Department of Preventive Medicine, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
| | - Hun‐Sung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
- Department of Medical Informatics, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
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Jimoh AK, Ghazali MS, Ogundeji OA, Adeleke BA, Ajani OG, Gabriel-Alayode EO, Popoola GO, Adediran OS. Spectrum of thyroid function test among type 2 diabetic patients attending a rural health facility, southwest Nigeria: A hospital-based study. SAGE Open Med 2022; 10:20503121221097625. [PMID: 35600708 PMCID: PMC9118895 DOI: 10.1177/20503121221097625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 04/11/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives: The thyroid gland produces hormones that have significant influence on carbohydrate metabolism; its disorders may affect carbohydrate metabolism in type 2 diabetic patients (T2DM) more than the non-diabetic (NDM) patients as reported in various studies. We determined the spectrum of thyroid function tests (TFTs) profile among T2DM in our rural health facility. Methods: T2DM patients and NDM patients were recruited for the study. The age, educational level, occupation, marital status, and duration of diabetes were extracted from interviewer’s administered questionnaire. The weight, height, body mass indices (BMIs), and the waist and hip circumferences were measured. Waist-hip ratios (WHR) were calculated for all participants. Venous blood was collected and assayed for free triiodothyronine (fT3), free thyroxine (fT4), and thyroid stimulating hormone (TSH) using a Chemiluminescence Immunoassay (CLIA) 2nd Generation Autoanalyzer. The mean, standard deviation, frequencies, and percentages were calculated for the variables. The student’s t-test and chi-square test were also determined as appropriate. Results: Seventy-eight patients made up of 56 T2DM and 22 NDM were evaluated in this study. Fifty-one were males while 27 were females; 67.9% and 59.1% of the female participants were T2DM and NDM, respectively. The WHR was significantly higher in T2DM than NDM (0.92 ± 0.05 versus 0.88 ± 0.06). The TSH was higher in T2DM than the NDM. Forty-four (78.6%) of the T2DM had euthyroid (normal) biochemical pattern; 12 (21.4%) showed abnormal biochemical pattern of euthyroid sick syndrome, subclinical hyperthyroid, and subclinical hypothyroid. Thirty (53.6%) of the T2DM were diagnosed less than five years ago. The value of TSH was increasing with the duration of diabetes but not in a statistically significant way. None of the T2DM showed overt hypothyroid or hyperthyroid test result. Conclusion: Thyroid function test may identify diabetics with altered thyroid hormone status that may impact on their metabolic control. Knowledge of the functional state of the thyroid gland can help in achieving a better metabolic control and attenuate the development of complications in T2DM.
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Affiliation(s)
- Ahmed Kayode Jimoh
- Department of Chemical Pathology, Afe Babalola University, Ado-Ekiti, Nigeria
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Li Y, Yi M, Deng X, Li W, Chen Y, Zhang X. Evaluation of the Thyroid Characteristics and Correlated Factors in Hospitalized Patients with Newly Diagnosed Type 2 Diabetes. Diabetes Metab Syndr Obes 2022; 15:873-884. [PMID: 35340987 PMCID: PMC8947801 DOI: 10.2147/dmso.s355727] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/03/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Diabetes mellitus (DM) and thyroid dysfunction (TD) are two closely associated disorders. The objective of the present study was to investigate the thyroid status and the relationships between thyroid hormones, diabetic complications and metabolic parameters in hospitalized patients with newly diagnosed type 2 DM (T2DM). METHODS This was an observational cross-sectional study, conducting on 340 patients with newly diagnosed T2DM who were admitted to ward of endocrinology department and 120 matched individuals without diabetes. Anthropometric, clinical and biochemical data were collected. Spearman correlation coefficients were calculated to evaluate the correlations between thyroid hormones and other variables. Factors associated with diabetic nephropathy (DN) was analyzed with multivariate logistic regression. RESULTS Levels of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) were significantly lower in patients with T2DM as compared to control group without diabetes. The prevalence of TD was 21.2% in patients with diabetes, higher than that in controls (4.2%). The low T3 syndrome was the most frequent TD, shown in 14.7% of patients. The presence of diabetic complications DN, diabetic ketosis or ketoacidosis), metabolic and demographic factors, including age, glycemic control and insulin resistance were factors significantly associated with levels of thyroid hormones. FT3 level was inversely correlated with the level of urinary total protein (mg/24h) and the presence of DN. Multivariate analysis indicated low FT3 level as a strong independent risk factor (OR = 0.364, P = 0.001) for DN. CONCLUSION TD is not rarely seen in hospitalized patients with newly diagnosed T2DM. Diabetic complications and diabetes-related metabolic and demographic factors are related to thyroid hormone levels. Decreased FT3 is strongly correlated with the presence of DN.
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Affiliation(s)
- Yanli Li
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Min Yi
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Xiaoyi Deng
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Wangen Li
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Yimei Chen
- Health Examination Department, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Xiaodan Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
- Correspondence: Xiaodan Zhang, Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, 250 East Changgang Road, Haizhu District, Guangzhou, 510260, People’s Republic of China, Email
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Sun X, Chen L, Wu R, Zhang D, He Y. Association of thyroid hormone with body fat content and lipid metabolism in euthyroid male patients with type 2 diabetes mellitus: a cross-sectional study. BMC Endocr Disord 2021; 21:241. [PMID: 34872554 PMCID: PMC8650347 DOI: 10.1186/s12902-021-00903-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 11/18/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND This study aimed to explore the associations of thyroid hormones with body fat content and lipid metabolism in euthyroid male patients with type 2 diabetes mellitus (T2DM). METHODS In January 2017, a cross sectional study, 66 male patients with T2DM who met the World Health Organization diagnostic criteria of 1999 who were ≥ 18.0 years and had normal thyroid function were recruited at a tertiary hospital. The categories of thyroid hormones (free triiodothyronine [FT3], free thyroxine [FT4], and thyroid-stimulating hormone [TSH]) were divided into three groups according to tertiles of thyroid hormones. RESULTS The mean FT3, FT4, and TSH of the patients were 2.56 pg/mL, 1.03 ng/dL, and 1.50 μIU/mL, respectively. Increased FT3 were associated with higher body mass index (BMI) (P < 0.001), body fat percentage (BFP) (P = 0.008), visceral fat content (VFC) (P = 0.019), adiponectin (P = 0.037), tumor necrosis factor alpha (TNF-α) (P < 0.001), and interleukin 6 (IL-6) (P = 0.015). There were significant differences among the different FT4 categories for BMI (P = 0.033), waist-hip ratio (WHR) (P = 0.030), low-density lipoprotein cholesterol (LDL-C) (P = 0.014), and IL-6 (P = 0.009). Increased TSH could increase the total cholesterol (TC) (P = 0.005) and high-density lipoprotein cholesterol (HDL-C) (P = 0.010). FT3 was positively correlated with BMI (r = 0.45; P < 0.001), WHR (r = 0.27; P = 0.028), BFP (r = 0.33; P = 0.007), VFC (r = 0.30; P = 0.014), adiponectin (r = 0.25; P = 0.045), TNF-α (r = 0.47; P < 0.001), and IL-6 (r = 0.32; P = 0.008). FT4 was positively correlated with HDL-C (r = 0.26; P = 0.038), LDL-C (r = 0.26; P = 0.036), and adiponectin (r = 0.28; P = 0.023). TSH was positively correlated with TC (r = 0.36; P = 0.003). CONCLUSION This study found that the changes in thyroid hormones are associated with various body fat content and lipid metabolism in euthyroid male patients with T2DM.
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Affiliation(s)
- Xia Sun
- Department of Endocrinology, Lishui Hospital of Traditional Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui, Zhejiang, 323000, China.
| | - Liping Chen
- Department of Cardiovascular Medicine, Lishui Hospital of Traditional Chinese Medicine, Lishui, Zhejiang, China
| | - Rongzhen Wu
- Department of Clinical Laboratory, Lishui Municipal Central Hospital, Lishui, Zhejiang, China
| | - Dan Zhang
- Department of Endocrinology, Lishui Municipal Central Hospital, Lishui, Zhejiang, China
| | - Yinhui He
- Department of Endocrinology, Lishui Municipal Central Hospital, Lishui, Zhejiang, China
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Li Z, Yu X, Ren L, Wang Z, Wang F, Jia Y, Chen S. Influence of Low Total Triiodothyronine Levels on Bone Turnover Markers in Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes 2021; 14:2727-2733. [PMID: 34163200 PMCID: PMC8215934 DOI: 10.2147/dmso.s309079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/11/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The aim of this study was to investigate whether low total triiodothyronine (TT3) could affect bone turnover in patients with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS This is a cross-sectional study that recruited 577 patients with T2DM, 141 patients formed the low TT3 group (TT3<1.30nmol/L) and 436 patients formed the control group (TT3≥1.30nmol/L), and the low TT3 group was further subdivided into four groups based on the TT3 level. To investigate whether TT3 level is associated with poor glycemic control, all participants were divided into high glycosylated hemoglobin (HbA1c) group and low HbA1c group using HbA1c 10.5% as the boundary. RESULTS The levels of OC and PINP were significantly lower in the low TT3 group compared with the control group (P < 0.05). TT3 positively correlated with OC and PINP (r = 0.219, P = 0.009; r = 0.208, P = 0.019) in the low TT3 group, and this positive correlation still existed after adjusting for other factors in multilinear regression analysis. Next, we want to find a cut-off point to prevent osteoporosis, we divided the patients in the low TT3 group into four groups based on the TT3 level, the levels of OC and PINP were significantly lower in the TT3 < 1.00 nmol/L group than in the TT3 ≥ 1.00 nmol/L groups. CONCLUSION In patients with T2DM, low TT3 levels are associated with impaired bone formation. What's more, bone formation was significantly impaired when TT3 was <1.00 nmol/L.
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Affiliation(s)
- Zelin Li
- Graduate School of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Xian Yu
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Luping Ren
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Zi Wang
- Department of Infectious Diseases, Shanghai Fourth People’ s Hospital, Shanghai, People’s Republic of China
| | - Fei Wang
- Graduate School of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Yujiao Jia
- Graduate School of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Shuchun Chen
- Graduate School of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
- Hebei Key Laboratory of Metabolic Diseases, Shijiazhuang, Hebei, People’s Republic of China
- Correspondence: Shuchun Chen Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of ChinaTel +86 31185988406Fax +86 31185988406 Email
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Kocatürk E, Kar E, Küskü Kiraz Z, Alataş Ö. Insulin resistance and pancreatic β cell dysfunction are associated with thyroid hormone functions: A cross-sectional hospital-based study in Turkey. Diabetes Metab Syndr 2020; 14:2147-2151. [PMID: 33395774 DOI: 10.1016/j.dsx.2020.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/06/2020] [Accepted: 11/08/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS The prevalence of thyroid disease in diabetic patients is significantly higher than the general population. This indicates a possible interaction between thyroid functions and insulin sensitivity. This study aimed to investigate the relationship between insulin resistance (IR), pancreatic β cell function, and thyroid function tests. METHODS This cross-sectional study was conducted with adults who applied to Eskişehir Osmangazi University Hospital for general control. Fasting insulin, glucose, TSH, fT3, and fT4 levels in the serum of 1340 adult (18-60 aged) patients without any chronic diseases were examined retrospectively. The fT3/fT4 ratio, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), and HOMA-β values were calculated. The correlation between HOMA-IR and HOMA-β values with thyroid function tests and differences between hormone levels of patients with and without IR were evaluated. RESULTS There was a positive correlation between HOMA-IR and TSH, negative with fT4. Also, a positive correlation between HOMA-β and fT3, negative correlation with fT4 were observed. In the IR group, fT3 levels were found significantly higher and fT4 levels were significantly lower. TSH levels were higher in the IR group but not statistically significant. The fT3/fT4 ratio was found significantly higher in the IR group and was correlated positively with both HOMA-IR and HOMA-β. CONCLUSION Our results revealed that thyroid dysfunction prevalence is quite high in adults who have not yet been diagnosed with diabetes but have insulin resistance and the onset of pancreatic β cell dysfunction.
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Affiliation(s)
- Evin Kocatürk
- Department of Medical Biochemistry, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey.
| | - Ezgi Kar
- Department of Medical Biochemistry, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
| | - Zeynep Küskü Kiraz
- Department of Medical Biochemistry, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey.
| | - Özkan Alataş
- Department of Medical Biochemistry, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey.
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Mehalingam V, Sahoo J, Bobby Z, Vinod KV. Thyroid dysfunction in patients with type 2 diabetes mellitus and its association with diabetic complications. J Family Med Prim Care 2020; 9:4277-4281. [PMID: 33110845 PMCID: PMC7586566 DOI: 10.4103/jfmpc.jfmpc_838_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/14/2020] [Accepted: 06/24/2020] [Indexed: 11/30/2022] Open
Abstract
Background and Aims: Patients with type 2 diabetes mellitus are more prone to thyroid disorders. Hypothyroidism in them leads to an aggravation of microvascular complications. Diabetic patients with hypothyroidism also are at an increased risk of cardiovascular disease. Screening for thyroid dysfunction in diabetic patients will allow early treatment of hypothyroidism. The aim of this study was to assess the level of thyroid dysfunction in patients with type 2 diabetes mellitus and to identify the association of thyroid dysfunction with diabetic complications. Methods: This is a cross-sectional study that was conducted at departments of Medicine & Endocrinology in JIPMER, Pondicherry, between June 2016 and May 2019. 331 patients with type 2 diabetes mellitus attending the out-patient department without any prior history of thyroid disease, chronic liver disease or acute illness were recruited for the study. All subjects were screened for diabetic complications (nephropathy, neuropathy, retinopathy & cardiovascular disease). Thyroid function test was done in all subjects using chemiluminescent immunoassay method. Results: Hypothyroidism was seen in 13.9%, while hyperthyroidism was observed in 3.6% of the study subjects. Thyroid dysfunction was more common among females than males. No correlation was seen between thyroid dysfunction and diabetic complications in the study subjects. Conclusion: The prevalence of thyroid dysfunction is 17.5% in patients with type 2 diabetes mellitus. Thyroid dysfunction did not have any correlation with diabetic complications.
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Affiliation(s)
- Vadivelan Mehalingam
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India
| | - Jayaprakash Sahoo
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India
| | - Zachariah Bobby
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India
| | - Kolar Vishwanath Vinod
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India
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Reddy N, Pradeep TVS, Tirupati S, Sarathi V, Kumar D. Thyroid dysfunction and its association with microvascular complications in patients with type 2 diabetes mellitus in south India. Diabetes Metab Syndr 2020; 14:615-617. [PMID: 32422445 DOI: 10.1016/j.dsx.2020.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 05/03/2020] [Accepted: 05/04/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIMS To study the prevalence of thyroid disorders and their association with microvascular complications among adult type 2 diabetes mellitus (T2DM) patients from south-coastal Andhra Pradesh, India METHODS: This cross-sectional study included 500 subjects with T2DM and was conducted in a tertiary health care center from south-coastal Andhra Pradesh. Participants previously diagnosed with thyroid disorders were excluded from the study. RESULTS Thyroid dysfunction was observed in 98 (19.6%) subjects of which subclinical hypothyroidism (n = 66, 13.2%) was the most common. Subclinical hypothyroidism (SCH) was more frequent in obese patients (16.2% vs 7.6%, p = 0.007) and metformin users (9.6% vs 18.7%, p = 0.0044). Diabetic retinopathy (27.3% vs 8.9%, p = 0.001) was significantly more frequent in SCH patients than euthyroid T2DM patients. CONCLUSION Among T2DM patients from south-coastal Andhra Pradesh the prevalence of thyroid dysfunction, especially that of SCH was high; SCH was more frequent among obese and nonmetformin users and was associated was associated with increased risk of diabetic retinopathy.
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Affiliation(s)
- Nishitha Reddy
- Department of Endocrinology, Narayana Medical College, Nellore, Andhra Pradesh, 524003, India
| | - T V S Pradeep
- Department of Endocrinology, Narayana Medical College, Nellore, Andhra Pradesh, 524003, India
| | - Sunanda Tirupati
- Department of Endocrinology, Narayana Medical College, Nellore, Andhra Pradesh, 524003, India
| | - Vijaya Sarathi
- Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, 560066, India.
| | - Dileep Kumar
- Department of Endocrinology, Narayana Medical College, Nellore, Andhra Pradesh, 524003, India
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Nie X, Shen Y, Ma X, Xu Y, Wang Y, Zhou J, Bao Y. Associations Between Thyroid Hormones and Glycated Albumin in Euthyroid and Subclinical Hypothyroid Individuals: Results of an Observational Study. Diabetes Metab Syndr Obes 2020; 13:915-923. [PMID: 32273743 PMCID: PMC7104252 DOI: 10.2147/dmso.s236698] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 03/12/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Although overt thyroid dysfunction has been found to influence the level of glycated albumin (GA), the associations between thyroid hormones and GA in individuals with euthyroidism and subclinical hypothyroidism (SHypo) are still unknown. The present study aimed to investigate whether thyroid hormones were related to GA in euthyroid and SHypo individuals. METHODS We recruited 685 euthyroid and 103 SHypo subjects with normal weight from communities in Shanghai. Electrochemiluminescence immunoassay was used to detect the serum levels of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone. GA was detected by the enzymatic method. Glycated hemoglobin (HbA1c) was detected by high-performance liquid chromatography. RESULTS Among the 788 subjects (age range 31-81 years old), 307 were men and 481 were women. In the Spearman correlation analysis and multiple stepwise regression analysis, FT3 was negatively correlated with both GA and GA/HbA1c in euthyroid subjects (all P < 0.05). The values of GA and GA/HbA1c were reduced by approximately 0.30 and 0.05, respectively, for each 0.50 pmol/L increment in FT3. In SHypo subjects, FT4 was negatively associated with both GA and GA/HbA1c (all P < 0.05). The values of GA and GA/HbA1c were reduced by approximately 0.23 and 0.03, respectively, for each 1.00 pmol/L increment in FT4. CONCLUSION In euthyroid and SHypo subjects, more attention should be paid to the potential effects of individual differences in thyroid hormones on GA.
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Affiliation(s)
- Xiaomin Nie
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai200233, People’s Republic of China
| | - Yun Shen
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai200233, People’s Republic of China
| | - Xiaojing Ma
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai200233, People’s Republic of China
- Correspondence: Xiaojing Ma; Yuqian Bao Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, 600 Yishan Road, Shanghai200233, People’s Republic of ChinaTel +86-21-64369181Fax +86-21-64368031 Email ;
| | - Yiting Xu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai200233, People’s Republic of China
| | - Yufei Wang
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai200233, People’s Republic of China
| | - Jian Zhou
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai200233, People’s Republic of China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai200233, People’s Republic of China
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12
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Kalra S, Aggarwal S, Khandelwal D. Thyroid Dysfunction and Type 2 Diabetes Mellitus: Screening Strategies and Implications for Management. Diabetes Ther 2019; 10:2035-2044. [PMID: 31583645 PMCID: PMC6848627 DOI: 10.1007/s13300-019-00700-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Indexed: 12/20/2022] Open
Abstract
Diabetes mellitus (DM) and thyroid dysfunction (TD) often tend to coexist in patients. Both hypothyroidism and hyperthyroidism are more common in type 2 diabetes mellitus (T2DM) patients than in their nondiabetic counterparts. Current guidelines are neither clear nor specific about the frequency of thyroid function monitoring in T2DM patients. Circulating thyroid hormones affect several different organs and cells, have a major impact on glucose, lipid, and protein metabolism, and can worsen glycaemic control in T2DM. Hyperthyroidism and thyrotoxicosis can worsen subclinical DM and cause hyperglycaemia in T2DM patients, increasing the risk of diabetic complications. T2DM reduces thyroid-stimulating hormone levels and impairs the conversion of thyroxine (T4) to triiodothyronine (T3) in the peripheral tissues. Poorly managed T2DM can lead to insulin resistance and hyperinsulinaemia, which causes thyroid tissue proliferation and increases nodule formation and goitre size. In addition, while metformin can be beneficial in both T2DM and TD patients, other antidiabetics such as sulfonylureas, pioglitazone, and thiazolidinediones can negatively impact TD. Antithyroid drugs such as methimazole can impair glycaemic control in T2DM patients. Thyrovigilance in T2DM patients and diabetovigilance in TD patients may therefore be necessary to facilitate individualized care and management.Funding: Abbott India Ltd.
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13
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Xie J, Wang X, Zhang Y, Li H, Xu Y, Zheng D. The longitudinal effect of subclinical hypothyroidism on urine microalbumin-to-urine creatinine ratio in patients with type 2 diabetes mellitus. BMC Endocr Disord 2019; 19:84. [PMID: 31382952 PMCID: PMC6683563 DOI: 10.1186/s12902-019-0405-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 07/10/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND In patients with diabetes mellitus, the urinary microalbumin-to-urine creatinine ratio (UACR) can not only predict the occurrence of diabetic nephropathy but also can be a risk factor for cardiovascular disease and renal function damage. Current studies on subclinical hypothyroidism (SCH) and UACR are mainly cross-sectional studies, and the results suggest that SCH is an independent risk factor for UACR. To further explore the longitudinal effect of SCH on UACR, we carried out this study. METHODS This was a retrospective cohort study including 46 patients with type 2 diabetes mellitus and SCH in the Department of Endocrinology, The Affiliated Huai'an Hospital of Xuzhou Medical University from January 2013 to April 2018. At the same time, 96 patients with type 2 diabetes mellitus and euthyroid were chosen according to 1:2 approximately matched with age, sex and duration of diabetes mellitus. Univariate analysis, stratified analysis, and multiple linear regression analysis were used to investigate the effect of SCH on ΔUACR(ΔUACR = UACR after 1 year - baseline UACR) in patients with type 2 diabetes mellitus. RESULTS There was no significant difference between the baseline UACR, (p > 0.05). However, the ΔUACR was significantly higher in SCH group than euthyroid group, as shown by univariate analysis, stratified analysis and multiple linear regression analysis (β:-1.071, 95% CI: - 1.713--0.428), and the difference was statistically significant (all p < 0.05). CONCLUSION SCH is associated with an increased UACR in type 2 diabetes mellitus patients. It is necessary to screen for thyroid function in type 2 diabetes mellitus and increase the follow-up frequency of UACR in patients with SCH.
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Affiliation(s)
- Juan Xie
- The Affiliated Huai'an Hospital of Xuzhou Medical University, Huaian, 223002, Jiangsu, China
| | - Xiaoqing Wang
- The Affiliated Huai'an Hospital of Xuzhou Medical University, Huaian, 223002, Jiangsu, China
| | - Yiyuan Zhang
- The Affiliated Huai'an Hospital of Xuzhou Medical University, Huaian, 223002, Jiangsu, China
| | - Hailun Li
- The Affiliated Huai'an Hospital of Xuzhou Medical University, Huaian, 223002, Jiangsu, China
| | - Yong Xu
- The Affiliated Huai'an Hospital of Xuzhou Medical University, Huaian, 223002, Jiangsu, China.
| | - Donghui Zheng
- The Affiliated Huai'an Hospital of Xuzhou Medical University, Huaian, 223002, Jiangsu, China.
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14
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Gurunath S, Arun K, Krishna AV, Kavya L, Sridhar B. Clinical Evidence of Association Between Type-2 Diabetes Mellitus and Hypothyroidism with Therapeutic Relevance—An Observational Study. JOURNAL OF EXPLORATORY RESEARCH IN PHARMACOLOGY 2019; X:1-10. [DOI: 10.14218/jerp.2019.00001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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