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Moosazadeh M, Khakhki S, Bahar A, Hedayatizadeh-Omran A, Kheradmand M, Alizadeh-Navaei R, Ghadirzadeh E. The prevalence and determinants of diabetes mellitus and thyroid disorder comorbidity in Tabari cohort population. Sci Rep 2024; 14:17577. [PMID: 39080342 PMCID: PMC11289382 DOI: 10.1038/s41598-024-68569-3] [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: 04/03/2024] [Accepted: 07/25/2024] [Indexed: 08/02/2024] Open
Abstract
Studies have shown that the co-occurrence of diabetes mellitus (DM) and thyroid dysfunction (TD) exacerbates diabetes complications and imposes a financial burden on the healthcare system. Therefore, this study aimed to investigate the prevalence of TD-DM comorbidity and its associated risk factors. This cross-sectional study was conducted on enrollment phase data of the TABARI cohort population which consisted of 10,255 adults aged between 35 to 70 years old residing in Sari, Mazandaran, Iran from 2015 to 2017. A total of 9939 out of 10,255 individuals (96.92%) entered the study. The prevalence of TD among T2DM patients was 13.2%. The prevalence of T2DM among patients with TD was 9.2%. Furthermore, the prevalence of TD-DM comorbidity in the overall population was 2.2%. Logistic regression analysis revealed that the odds of TD-DM comorbidity was significantly higher in women (OR 2.85; 95% CI 1.58-5.11), in the age group of 60-70 years (OR 9.62; 95% CI 3.69-25.10), in smokers (OR 2.32; 95% CI 1.19-4.52), in individuals with high waist circumference (WC) (OR 2.22; 95% CI 1.32-3.75), in individuals with low high-density lipoprotein (HDL) (OR 1.60; 95% CI 1.20-2.14), in individuals with high total cholesterol (TC) (OR 1.71; 95% CI 1.21-2.41), in individuals with high triglycerides (TG) (OR 1.79; 95% CI 1.27-2.51), and significantly lower in individuals with higher physical activity (PA) (OR 0.67; 95% CI 0.49-0.93). The present study demonstrated a prevalence of 2.2% in patients with both TD and T2DM. Additionally, female gender, older age, smoking, high WC, low HDL, high TC, high TG, and low PA were predictors of TD-DM comorbidity.
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Affiliation(s)
- Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Saeedeh Khakhki
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Adele Bahar
- Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Akbar Hedayatizadeh-Omran
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Motahareh Kheradmand
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Erfan Ghadirzadeh
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
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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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Atia YA, Mohammed ST, Abdullah SS, Abbas AS, Fawzi HA. Effects of subclinical hypothyroidism in type II diabetes mellitus patients on biochemical, coagulation, and fibrinolysis status. J Adv Pharm Technol Res 2024; 15:130-134. [PMID: 38903550 PMCID: PMC11186545 DOI: 10.4103/japtr.japtr_89_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/01/2024] [Accepted: 04/05/2024] [Indexed: 06/22/2024] Open
Abstract
The aim of the currnet study to examine the effect of subclinical hypothyroidism (SCH) in diabetic patients on coagulation parameters. This retrospective case-control study involves 130 patients diagnosed with type 2 diabetes mellitus (T2DM), divided into 65 T2DM with newly diagnosed SCH and 65 euthyroid (EUT) T2DM patients without SCH. Fibrinogen (FIB) was significantly higher in SCH (508.2 ± 63.0 mg/dL) than EUT (428.1 ± 44.8 mg/dL). In the SCH patients, FIB correlated with several parameters, such as age (β = 0.396), body mass index (β = 0.578), glycated hemoglobin (β = 0.281), and activated partial thromboplastin time (β = 0.276). In conclusion SCH in DM patients appears to increase the magnitude of coagulopathy.
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Affiliation(s)
- Yasir Abbas Atia
- Department of Biochemistry, University of Baghdad Al-Kindy College of Medicine, Baghdad, Iraq
| | - Suhad Taha Mohammed
- Department of Biochemistry, University of Baghdad Al-Kindy College of Medicine, Baghdad, Iraq
| | | | - Ahmed Saad Abbas
- Department of Medicine, Al-Kindi Teaching Hospital, Baghdad, Iraq
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Bao S, Li F, Duan L, Li J, Jiang X. Thyroid-stimulating hormone may participate in insulin resistance by activating toll-like receptor 4 in liver tissues of subclinical hypothyroid rats. Mol Biol Rep 2023; 50:10637-10650. [PMID: 37884783 DOI: 10.1007/s11033-023-08834-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 09/19/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Thyroid-stimulating hormone (TSH) is an independent risk factor of and closely associated with metabolic disorders. In the present study, we explored the potential mechanism and adverse effects of TSH on insulin resistance in the liver of subclinical hypothyroidism models in vivo. METHODS The mean glucose infusion rate (GIR), free fatty acids (FFAs), the homeostatic model assessment for insulin resistance (HOMA-IR), fasting plasma insulin (FINS), the TLR4 signal pathway and its intracellular negative regulator-toll-interacting protein (Tollip), and the modulators of insulin signaling were evaluated. RESULTS Compared to the normal control group (NC group), the subclinical hypothyroidism rat group (SCH group) showed decreases in GIR and increases in FFAs, FINS, and HOMA-IR. The levels of TLR4 and of its downstream molecules like p-NF-κB, p-IRAK-1, IL-6 and TNF-α were evidently higher in the SCH group than in the NC group. Conversely, the level of Tollip was significantly lower in the SCH group than in the NC group. Compared to the NC group, the levels of phosphorylated IRS-1-Tyr and GLUT2 were decreased in the SCH group. Macrophage infiltration was higher in the SCH group than in the NC group. CONCLUSION TSH may participate in aggravating inflammation by increasing macrophage infiltration; furthermore, it may activate the TLR4-associated inflammatory signaling pathway, thus interfering with insulin signals in liver tissues. Targeting TSH may have therapeutic benefits against metabolic disorders.
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Affiliation(s)
- Suqing Bao
- Department of Endocrinology, Tianjin First Central Hospital, No. 24 Fu Kang Road, Nankai District, Tianjin, 300192, China.
| | - Fengbo Li
- Department of Orthopedics, Tianjin Hospital, No. 406 Jie fang South Road, Hexi District, Tianjin, 300211, China
| | - Lijun Duan
- Department of Endocrinology, Tianjin First Central Hospital, No. 24 Fu Kang Road, Nankai District, Tianjin, 300192, China
| | - Junfeng Li
- Department of Endocrinology, Tianjin First Central Hospital, No. 24 Fu Kang Road, Nankai District, Tianjin, 300192, China
| | - Xia Jiang
- Department of Endocrinology, Tianjin First Central Hospital, No. 24 Fu Kang Road, Nankai District, Tianjin, 300192, China
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Lin L, Du Y, Niu G, Xia S, Liu J. Folate deficiency may increase the risk for elevated TSH in patients with type 2 diabetes mellitus. BMC Endocr Disord 2023; 23:169. [PMID: 37563586 PMCID: PMC10416468 DOI: 10.1186/s12902-023-01422-2] [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: 11/17/2022] [Accepted: 07/21/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) and thyroid dysfunction (TD) are two common chronic endocrine disorders that often coexist. Folate deficiency has been reported to be related with the onset and development of T2DM. However, the relationship between folate deficiency and TD remains unclear. This study aims to investigate the association of serum folate with TD in patients with T2DM. METHODS The study used data on 268 inpatients with T2DM in the Beijing Chao-yang Hospital, Capital Medical University from October 2020 to February 2021. Thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), and serum folate were measured with chemiluminescence immunoassay (CLIA), and folate deficiency was defined as a serum folate concentration < 4.4 ng/mL. Ordinary least squares regression models were used to assess the association of serum folate with TSH concentration. Multivariable logistic regression models were performed to explore the correlation of folate deficiency and the risk for elevated TSH. RESULTS 15.3% of T2DM patients had TD. Among those patients with TD, 80.5% had elevated TSH. Compared with the normal-TSH and low-TSH groups, the prevalence of folate deficiency was significantly higher in the elevated-TSH group (P < 0.001). Serum folate level was negatively associated with TSH (β=-0.062, 95%CI: -0.112, -0.012). Folate deficiency was associated with the higher risk for elevated TSH in patients with T2DM (OR = 8.562, 95%CI: 3.108, 23.588). CONCLUSIONS A low serum folate concentration was significantly associated with a higher risk for elevated TSH among T2DM patients.
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Affiliation(s)
- Lin Lin
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yushan Du
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Guanyu Niu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Shuangbo Xia
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jufen Liu
- Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China.
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
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Li Q, Bi R. Relationship Between Serum 25-Hydroxyvitamin D Deficiency and Thyroid Disease in Postmenopausal Women with Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes 2023; 16:1407-1414. [PMID: 37213210 PMCID: PMC10199712 DOI: 10.2147/dmso.s404172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/25/2023] [Indexed: 05/23/2023] Open
Abstract
Purpose It is unknown whether there is an association between 25-hydroxyvitamin D (25(OH)D) level and thyroid disease in postmenopausal women with type 2 diabetes. This study aimed to evaluate the relationship between blood 25(OH)D levels and thyroid function in postmenopausal women with type 2 diabetes mellitus (T2DM). Methods This cross-sectional study involved Chinese postmenopausal women who presented to our diabetes clinic from March 2021 to May 2022 and were diagnosed with T2DM collected via a convenience sampling method. Blood samples were obtained from each patient to detect serum thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free T3 (FT3), free T4 (FT4), thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb) and 25(OH)D levels. Deficiency was defined as a 25(OH)D < 20 ng/mL. Comparative analysis was via t-test or chi-square test. Pearson correlation was then used to estimate the relationship between different thyroid function parameters and 25(OH)D. Multivariate logistic regression analysis was used to explore potential risk factors for 25(OH)D deficiency. Results In total, 157 out of 230 participants (68.26%) had 25(OH)D deficiency. Compared with patients with normal 25(OH)D levels, patients with 25(OH)D deficiency had shorter medical histories of diabetes mellitus (DM, p = 0.001) and higher rates of hyperthyroidism (p = 0.007), hypothyroidism (p < 0.001), TPOAb positive (p < 0.001) and TgAb positive (p < 0.001). Correlation analysis revealed that TSH (r = -0.144, p = 0.030), FT4 (r = -0.145, p = 0.029), TPOAb (r = -0.216, p = 0.001) and TgAb (r = -0.150, p = 0.024) levels were correlated with serum 25(OH)D levels. Further multivariable logistic regression analyses suggested that the length of DM history, presence of hyperthyroidism, presence of hypothyroidism and positive TPOAb were significantly associated with the presence of 25(OH)D deficiency in postmenopausal women with T2DM. Conclusion Hyperthyroidism, hypothyroidism and TPOAb positivity were significantly associated with the presence of 25(OH)D deficiency in postmenopausal women with T2DM.
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Affiliation(s)
- Quan Li
- Department of Clinical Laboratory, Yulin NO.2 Hospital, Yulin City, Shaanxi Province, 719000, People’s Republic of China
| | - Rui Bi
- Department of Obstetrics, Yulin NO.2 Hospital, Yulin City, Shaanxi Province, 719000, People’s Republic of China
- Correspondence: Rui Bi, Department of Obstetrics, Yulin NO.2 Hospital, Wenhua South Road, Yulin City, Shaanxi Province, 719000, People’s Republic of China, Tel +86-18992245891, Email
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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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Gao X, Wang X, Zhong Y, Liu L, Teng W, Shan Z. Serum Antithyroglobulin Antibody Levels Are Associated with Diabetic Retinopathy among Euthyroid Type 2 Diabetes Patients: A Hospital-Based, Retrospective Study. J Diabetes Res 2022; 2022:2552186. [PMID: 35036446 PMCID: PMC8758256 DOI: 10.1155/2022/2552186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Previous studies have revealed that the variation of thyroid indicators may be associated with the risk of diabetic retinopathy (DR) among euthyroid type 2 diabetes (T2D) patients. But the specific conclusions are currently inconsistent. METHODS This is a hospital-based retrospective survey. We recruited 1,145 euthyroid T2D patients and checked the thyroid function and fundus photographs. The modified Airlie House classification system was used to categorize the stages of DR. The association between thyroid indicators and different stages of DR was analyzed. RESULTS We divided free triiodothyronine (FT3) into tertiles and found that the prevalence of mild nonproliferative DR (NPDR) was significantly higher in T2, compared with T1 (32.0% vs. 25.2%, p < 0.05). When FT3 was within the level of T2, FT3 could be an independent risk factor for mild NPDR (OR 1.426, 95% CI (1.031, 1.971), p < 0.05). In addition, the prevalence of severe NPDR and proliferative DR (PDR) was significantly higher in thyroglobulin antibody (TgAb) positive group (8.8% vs. 4.1%, p < 0.05) and vice versa (33.3% vs. 18.4%, p < 0.05). TgAb positivity was also an independent risk factor for severe NPDR and PDR (OR 2.212, 95% CI (1.244, 3.934), p < 0.05). CONCLUSIONS We hardly observed a significant change in DR risk with the elevation or reduction of serum TSH or thyroid hormone within the reference interval. Although the slightly elevated FT3 may be associated to mild NPDR, the extensibility of this result remains to be seen. For T2D patients with euthyroid function, there may be a significant correlation between serum TgAb positivity and severe NPDR and PDR.
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Affiliation(s)
- Xiaotong Gao
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang 110001, China
| | - Xichang Wang
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang 110001, China
| | - Yifan Zhong
- Department of Ophthalmology, The First Hospital of China Medical University, Shenyang 110001, China
| | - Lei Liu
- Department of Ophthalmology, The First Hospital of China Medical University, Shenyang 110001, China
| | - Weiping Teng
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang 110001, China
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang 110001, China
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Hauge C, Breitschaft A, Hartoft-Nielsen ML, Jensen S, Bækdal TA. Effect of oral semaglutide on the pharmacokinetics of thyroxine after dosing of levothyroxine and the influence of co-administered tablets on the pharmacokinetics of oral semaglutide in healthy subjects: an open-label, one-sequence crossover, single-center, multiple-dose, two-part trial. Expert Opin Drug Metab Toxicol 2021; 17:1139-1148. [PMID: 34289755 DOI: 10.1080/17425255.2021.1955856] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Oral semaglutide comprises the glucagon-like peptide-1 analog, semaglutide, and sodium N-(8-[2-hydroxybenzoyl] amino) caprylate (SNAC). Levothyroxine has similar dosing conditions to oral semaglutide. This trial investigated if oral semaglutide co-administered with levothyroxine affects thyroxine (T4) exposure and if multiple placebo tablets co-administered with oral semaglutide affect semaglutide exposure. RESEARCH DESIGN AND METHODS In this one-sequence crossover trial, 45 healthy subjects received levothyroxine (600 μg single-dose) alone, or with concomitant SNAC 300 mg or concomitant oral semaglutide 14 mg at steady-state. Subjects also received oral semaglutide 14 mg at steady-state alone or with five placebo tablets once-daily for 5 weeks. RESULTS A 33% increase in total T4 exposure was observed with levothyroxine/oral semaglutide vs levothyroxine alone, but baseline-corrected maximum concentration (Cmax) was unaffected. SNAC alone did not affect total T4 exposure, whereas Cmax was slightly decreased. A 34% decrease in semaglutide exposure was observed when oral semaglutide was co-administered with placebo tablets, and Cmax also decreased. CONCLUSIONS Levothyroxine pharmacokinetics were influenced by co-administration with oral semaglutide. Monitoring of thyroid parameters should be considered when treating patients with both oral semaglutide and levothyroxine. Oral semaglutide exposure was influenced by co-administration with multiple tablets, which is addressed in the dosing guidance.
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Affiliation(s)
- Camilla Hauge
- Clinical Pharmacology, Novo Nordisk A/S, Søborg, Denmark
| | | | | | - Simon Jensen
- Biostatistics, Novo Nordisk A/S, Søborg, Denmark
| | - Tine A Bækdal
- Clinical Pharmacology, Novo Nordisk A/S, Søborg, Denmark
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Luo J, Wang X, Yuan L, Guo L. Genome‑wide profiling of DNA methylation and gene expression unravel the epigenetic landscape in diabetes-related hypothyroidism. Clin Epigenetics 2021; 13:123. [PMID: 34092241 PMCID: PMC8182906 DOI: 10.1186/s13148-021-01109-2] [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] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/31/2021] [Indexed: 12/13/2022] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) and hypothyroidism are two common endocrine diseases and the phenomenon that the prevalence of diabetes-related hypothyroidism shows a significant upward trend deserves further attention, but the specific pathogenesis is not yet clear. The study aimed to explore the molecular mechanisms on DNA methylation regulating gene expression and participating in diabetes-related hypothyroidism through genome-wide DNA methylation and RNA sequencing. Results The prevalence of hypothyroidism in T2DM patients was significantly higher than that in patients without T2DM (P = 0.018). Meanwhile, high TSH and low T3 and T4 levels were detected in diabetic mice. Low T3 and T4 levels were detected in Nthy-ori3-1 cells incubated in high-glucose medium. Differentially expressed genes (DEGs) and differentially methylated regions (DMRs) were detected by RNA sequencing and reduced representation bisulfite sequencing in Nthy-ori3-1 cells cultured in high-glucose and normal medium. Functional enrichment analyses reveled that DMRs and DEGs were related to significant pathways including Ras, Wnt and MAPK pathways. Conclusions We observed the potential connection between T2DM and hypothyroidism. This study was the first one carrying out DNA methylation and gene expression profiles to explore epigenetic modification in diabetes-related hypothyroidism, which provided information for the detailed study of the molecular mechanism in diabetes-related hypothyroidism. Supplementary Information The online version contains supplementary material available at 10.1186/s13148-021-01109-2.
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Affiliation(s)
- Jingyi Luo
- Department of Endocrinology, The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, National Health Commission, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No.1 DaHua Road, Dong Dan, Beijing, 100730, People's Republic of China
| | - Xiaoxia Wang
- Department of Endocrinology, The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, National Health Commission, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No.1 DaHua Road, Dong Dan, Beijing, 100730, People's Republic of China
| | - Li Yuan
- The Savaid School of Medicine, University of Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Lixin Guo
- Department of Endocrinology, The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, National Health Commission, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No.1 DaHua Road, Dong Dan, Beijing, 100730, People's Republic of China.
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Liu Y, Shan Z. Expert consensus on diagnosis and treatment for elderly with thyroid diseases in China (2021). Aging Med (Milton) 2021; 4:70-92. [PMID: 34250426 PMCID: PMC8251868 DOI: 10.1002/agm2.12165] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 01/15/2023] Open
Abstract
In order to improve the diagnosis and treatment of senile thyroid diseases in China and to promote healthy aging, the Endocrine Metabolic Diseases Group of the Chinese Geriatrics Society, and the Thyroid Group of the Chinese Society of Endocrinology jointly drafted the "Expert consensus on diagnosis and treatment for Chinese elderly with thyroid diseases" (referred to as consensus). The Consensus consists of five parts that set 40 recommendations on main clinical issues. The consensus emphasizes clinical focus on the age-related changes of the hypothalamus-pituitary-thyroid axis in the elderly, and it recommends application of comprehensive geriatric assessment to thoroughly evaluate the impact of thyroid diseases and relevant intervention on overall health condition. Meanwhile, it recommends generalization of screening for hypothyroidism during admission to nursing institution or hospital, and routine health check-ups. Furthermore, it develops individualized stratified management on hyperthyroidism, hypothyroidism, thyroid nodules, and differentiated thyroid carcinoma in the elderly distinguished from the youngers, including treatment regimen, control ranges, and flowcharts for diagnosis and treatment. The Consensus will provide the basis for clinical decisions and health management of thyroid diseases in the elderly by geriatrician, endocrinologist, and general practitioners.
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Affiliation(s)
- Youshuo Liu
- Department of Geriatrics and Geriatric EndocrinologyThe Second Xiangya Hospitaland the Institute of Aging and GeriatricsCentral South UniversityNational Clinical Research Center for Metabolic Diseases (The Second Xiangya Hospital)ChangshaChina
| | - Zhongyan Shan
- Department of Endocrinology and MetabolismThe Institute of EndocrinologyThe First Hospital of China Medical University, NHC Key Laboratory
Diagnosis and Treatment of Thyroid DiseasesShenyangChina
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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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Hoshi RA, Santos IS, Dantas EM, Andreão RV, Mill JG, Duncan BB, Schmidt MI, Lotufo PA, Bensenor I. Diabetes and subclinical hypothyroidism on heart rate variability. Eur J Clin Invest 2020; 50:e13349. [PMID: 32654127 DOI: 10.1111/eci.13349] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/29/2020] [Accepted: 07/07/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND We aimed to analyse if the effects of coexistent diabetes and subclinical hypothyroidism extend to the cardio autonomic nervous system, using heart rate variability baseline data from the Brazilian Longitudinal Study of Adult Health. MATERIALS AND METHODS Heart rate variability analyses were performed by linear time and frequency domains in 5-minute time series collected in the supine position. The associations of diabetes and subclinical hypothyroidism with the lowest quartile group for heart rate and the highest quartile group for each heart rate variability parameter were analysed using additive and multiplicative terms in logistic models. For the first approach, the subsample was categorized into four groups: subjects without diabetes and normal thyroid function (controls); subjects without diabetes and subclinical hypothyroidism; patients with diabetes and normal thyroid function; and patients with diabetes and subclinical hypothyroidism. For the interaction alnalysis, diabetes and subclinical hypothyroidism diagnoses were included in separate, along with a multiplicative interaction term between them. RESULTS Point odds ratio estimates for the 4th quartiles of heart rate, and 1st quartiles of all heart rate variability measurements were higher for subjects with combined diabetes and subclinical hypothyroidism than for diabetes only, independently of main sociodemographic and clinical variables (HR: 8.33 vs 2.63; SDNN: 2.59 vs 1.61; RMSSD: 2.37 vs 1.42; LF: 2.83 vs 1.71; HF: 3.06 vs 1.39), but not independently of HbA1c and TSH. Only the interaction term for the association with heart rate, adjusted for sociodemographic and clinical variables, had borderline statistical significance. CONCLUSION Diabetes and subclinical hypothyroidism exert a potential joint impact on cardiac autonomic control, showed by additive effects between diabetes and subclinical hypothyroidism, as well as a significant interaction term for the association with heart rate.
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Affiliation(s)
- Rosangela A Hoshi
- Center for Clinical and Epidemiological Research of University Hospital, University of Sao Paulo, Sao Paulo, Brazil
| | - Itamar S Santos
- Center for Clinical and Epidemiological Research of University Hospital, University of Sao Paulo, Sao Paulo, Brazil
| | - Eduardo M Dantas
- Department of Biological Sciences, Federal University of Vale do Sao Francisco, Petrolina, Brazil
| | - Rodrigo V Andreão
- Department of Electrical Engineering, Federal Institute of Espirito Santo, Vitória, Brazil
| | - José G Mill
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, Brazil
| | - Bruce B Duncan
- Department of Social Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria I Schmidt
- Postgraduate Programme in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research of University Hospital, University of Sao Paulo, Sao Paulo, Brazil
| | - Isabela Bensenor
- Center for Clinical and Epidemiological Research of University Hospital, University of Sao Paulo, Sao Paulo, Brazil
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Khassawneh AH, Al-Mistarehi AH, Zein Alaabdin AM, Khasawneh L, AlQuran TM, Kheirallah KA, Saadeh NA, Beni Yonis O, Shawkat M, Obeidat N. Prevalence and Predictors of Thyroid Dysfunction Among Type 2 Diabetic Patients: A Case-Control Study. Int J Gen Med 2020; 13:803-816. [PMID: 33116772 PMCID: PMC7568427 DOI: 10.2147/ijgm.s273900] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 09/14/2020] [Indexed: 01/22/2023] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) and thyroid disorders are common endocrine disorders. This case–control study aims to determine the prevalence and predictors of thyroid disorders in T2DM patients. Methods A total of 998 T2DM patients attending a tertiary hospital were included and underwent investigations for thyroid function: thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3); and glycated hemoglobin (HbA1c). They were compared with 343 non-diabetic subjects as controls. Results A total of 1341 participants were included in the study. The mean age ± SD was 60.14 ± 12.21, and 47.9% were females. Among T2DM patients, 140 (14%) were known to have thyroid disorders; and as a direct result of screening, 126 (12.6%) new cases of thyroid disorder were diagnosed. Thus, the overall prevalence of thyroid disorders was found to be 26.7% in T2DM patients which significantly higher than the controls (13.7%), (p˂0.001). Subclinical hypothyroidism was the most common one. Using logistic regression, after adjusting for age, gender, obesity, smoking, anemia, presence of goiter, disease duration, and poorly controlled, the risk factors for thyroid dysfunction among T2DM patients were an age of ≥50 years with an adjusted OR of 3.895 (95% CI 2.151–7.052, p<0.001); female gender (OR 1.757, 95% CI 1.123–2.747, p=0.013); goiter (OR 2.904, 95% CI 1.118–7.547, p=0.029), and HbA1c>7% (OR 2.553, 95% CI 1.472–4.429, p=0.001). However, there were no significant associations between thyroid disorders and complications or duration of diabetes (p>0.050). Conclusion A high prevalence of thyroid disorders was reported in T2DM patients. Therefore, we suggest that diabetic patients should be routinely screened for thyroid dysfunction. Old age, female gender, goiter, and poorly controlled diabetes found to be risk factors for thyroid dysfunction among T2DM patients. Consequently, appropriate management and control of diabetes may lower the risk of thyroid dysfunction and vice versa.
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Affiliation(s)
- Adi H Khassawneh
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdel-Hameed Al-Mistarehi
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Anas M Zein Alaabdin
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Laith Khasawneh
- Department of Surgery, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Thekraiat M AlQuran
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalid A Kheirallah
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Nesreen A Saadeh
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Othman Beni Yonis
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohamid Shawkat
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Nail Obeidat
- Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Wang L, Chen T, Yu J, Yuan H, Deng X, Zhao Z. Clinical Associations of Thyroid Hormone Levels with the Risk of Atherosclerosis in Euthyroid Type 2 Diabetic Patients in Central China. Int J Endocrinol 2020; 2020:2172781. [PMID: 32714391 PMCID: PMC7354656 DOI: 10.1155/2020/2172781] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/13/2020] [Accepted: 06/17/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Thyroid function is associated with the etiology and pathogenesis of type 2 diabetes (T2D) and potentially contributes to the development of the complications of T2D. The association of thyroid hormones with atherosclerosis in euthyroid T2D patients is not clear. PURPOSE To investigate the association of thyroid hormone levels with the risk of developing atherosclerosis in euthyroid T2D patients in Central China. METHODS This cross-sectional study recruited 910 euthyroid T2D patients from Henan Provincial People's Hospital, China. Association among hemoglobin A1c (HbA1c), thyroid hormones, and the prevalence of atherosclerosis was assessed by multivariable Cox models after adjusting for covariates including age, BMI, duration of T2D, smoking status, SBP, TC, family history of T2D, and medications on hyperlipidemia. RESULTS Among all 910 subjects, 373 were diagnosed with atherosclerosis. There were 523 females and 387 males included in this study. The mean age was 51.9 years. The average BMI was 25.3 kg/m2. Low-normal serum-free triiodothyronine (FT3) levels (3.50-4.17 pmol/L) were associated with a high prevalence of atherosclerosis. Comparing with low-normal FT3, the prevalence ratio in patients with mid- (4.17-4.83 pmol/L) and high-normal FT3 level (4.83-6.50 pmol/L) is 0.74 (95% CI 0.56 to 0.97, p=0.029) and 0.63 (95% CI 0.46 to 0.87, p=0.005) after adjusting for covariates. High level of free thyroxine (FT4) also had decreased risk for atherosclerosis. Thyroid-stimulating hormone (TSH) and FT3 to FT4 ratio did not show significant association with the development of atherosclerosis. CONCLUSION T2D patients with low but clinically normal FT3 level are more likely to develop macrovascular complications comparing with those with mid- and high-normal FT3 level.
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Affiliation(s)
- Limin Wang
- Department of Endocrinology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan 450003, China
| | - Tingting Chen
- School of Food Science, State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, Jiangxi 330047, China
| | - Jiawei Yu
- Department of Nephrology, The People's Liberation Army No. 988 Hospital, Zhengzhou, Henan 450003, China
| | - Huijuan Yuan
- Department of Endocrinology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan 450003, China
| | - Xinru Deng
- Department of Endocrinology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan 450003, China
| | - Zhigang Zhao
- Department of Endocrinology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan 450003, China
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