Association Between Changes in Thyroid Hormones and Incident Type 2 Diabetes: A Seven-Year Longitudinal Study

Jun, Ji Eun; Jee, Jae Hwan; Bae, Ji Cheol; Jin, Sang‐Man; Hur, Kyu Yeon; Lee, Moon‐Kyu; Kim, Tae Hyuk; Kim, Sun Wook; Kim, Jae Hyun

doi:10.1089/thy.2016.0171

Cited by 49 publications

(43 citation statements)

References 41 publications

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“…The results of the present study are in line with the results of the cohort study from South Korea, where the baseline plasma TSH levels in the normal range were not associated with increased risk of incident T2DM [18]. Interestingly, the authors of that study found an association between an increase in plasma TSH levels over time and incident T2DM.…”

Section: Discussionsupporting

confidence: 91%

“…of males (%)Reference range TSHAdjusted variablesChaker et al, 2016 [17]Netherlands, Rotterdam Study71886857.9 years12.1 per 1000 person-years64.6 years3553 (42%)0.4-4.0 mIU/LAge, sex, smoking, cohort, fasting serum glucose levels, fasting serum insulin, SBP, DBP, blood pressure lowering medication, HDL-C, BMIJun et al, 2017 [18]South Korea17,0619565.0 years11.2 per 1000 person-years50.5 years10,318 (60%)0.4–4.2 mIU/LAge, sex, smoking status, use of lipid drug, HbA1c, TG, HDL-C, LDL-C, hypertension, BMI, fasting glucose, family history of T2DMde Vries et al, 2017 (present study)Netherlands, SMART study55422895.6 years9.2 per 1000 person-years56.1 years3589 (65%)0.35-5.0 mIU/LAge, sex, current smoking, total and HDL-C, and TG, (fasting glucose, BMI, SBP, lipid lowering medication, blood pressure lowering medication) T2DM type 2 diabetes mellitus, TSH thyroid stimulating hormone, SBP systolic blood pressure, DBP diastolic blood pressure, HDL-C high-density lipoprotein cholesterol, LDL-C low-density lipoprotein cholesterol, BMI body mass index, HbA1c glycated hemoglobin A1c, TG triglycerides …”

Section: Resultsmentioning

confidence: 99%

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Thyroid-stimulating hormone levels in the normal range and incident type 2 diabetes mellitus

et al. 2018

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AimTo evaluate the relationship between thyroid-stimulating hormone (TSH) levels within the normal range and the risk of type 2 diabetes mellitus (T2DM) in a cohort of patients at high cardiovascular risk, and to perform a systematic review and meta-analysis of previous studies.MethodsWe included 5542 patients without T2DM from the prospective Secondary Manifestations of ARTerial disease study with TSH levels between 0.35 and 5.0 mIU/L without anti-thyroid medication or thyroid-hormone replacement therapy. Cox regression was used to investigate the relationship between baseline plasma TSH levels and incident T2DM. MEDLINE, EMBASE, and Cochrane were searched for prospective cohorts assessing TSH and incident T2DM. Hazard ratios (HR) from included prospective cohort studies were pooled using a random-effects model.ResultsIn patients at high cardiovascular risk, higher plasma TSH levels in the normal range were not associated [HR 1.07 per mIU/L increase in TSH (95% confidence interval (95% CI) 0.95–1.22)] with an increased risk of T2DM, adjusted for age, sex, smoking, total and HDL cholesterol, and triglycerides. In the meta-analysis involving three prospective cohort studies, including the present study, including 29,791 participants with 1930 incident events, there was no relation between plasma TSH levels in the normal range and incident T2DM [pooled HR 1.06 (95% CI 0.99–1.14)].ConclusionThere is no apparent relation between plasma TSH levels in the normal range and incident T2DM in patients at high cardiovascular risk.Electronic supplementary materialThe online version of this article (10.1007/s00592-018-1231-y) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 91%

Section: Resultsmentioning

confidence: 99%

Thyroid-stimulating hormone levels in the normal range and incident type 2 diabetes mellitus

et al. 2018

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“…In addition, our results revealed that no correlation and interaction exist between HbA1c and TSH. This finding is consistent with the previous report of a seven-year longitudinal study51, which suggests that the effects of high normal baseline HbA1c and TSH on the development of CHD may result from different pathological pathways, although the two parameters are related to glucose and lipid metabolisms. Hence, the combination of baseline HbA1c and TSH is valuable for identifying individuals who will later develop CHD.…”

Section: Discussionsupporting

confidence: 93%

Association of high normal HbA1c and TSH levels with the risk of CHD: a 10-year cohort study and SVM analysis

Cui

Zhu

et al. 2017

Sci Rep

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This study aimed to determine the association between the clinical reference range of serum glycated hemoglobin A1c (HbA1c) and thyrotropin (TSH) and the risk of coronary heart disease (CHD) in non-diabetic and euthyroid patients. We examined baseline HbA1c and TSH in 538 healthy participants, and then analyzed the associations and potential value of these indicators for predicting CHD using Cox proportional hazard and support vector machine analyses. During the median follow-up of 120 months, 39 participants later developed CHD. The baseline HbA1c and TSH within the reference range were positively associated with CHD risk. No correlation and interaction were found between the baseline HbA1c and TSH for the development of CHD. Disease event-free survival varied among participants with different baseline HbA1c quintiles, whereas disease event-free survival was similar for different TSH tertiles. The combination of these baselines showed sensitivity of 87.2%, specificity of 92.7%, and accuracy of 92.3% for identifying the participants who will later develop CHD. Relatively high but clinically normal HbA1c and TSH levels may increase the risk of CHD. Therefore, the combination of these indicators can serve as a biomarker for identifying healthy individuals from those who would later develop CHD.

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“…Changes in serum TSH correlated with changes in glicaeted hemoglobin (HbA1c), which represents the main indicator of the average glycemic control over 2-3 months (117). The same group of authors reported that individual changes in TSH and thyroid hormones, even within the normal reference range, were an additional risk factor of incident T2DM during a seven-year longitudinal study on 6,235 euthyroid subjects without T2D (118). A progressive increase in TSH with a decrease in T3 and FT4, suggesting the development of a more severe form of hypothyroidism, was independently associated with the risk of developing T2D regardless of sex and thyroid autoimmunity.…”

Section: Changes In Tsh And/ or Th In Longitudinal Studies And Incidementioning

confidence: 98%

Thyroid Dysfunction and Diabetes Mellitus: Two Closely Associated Disorders

2019

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Association Between Changes in Thyroid Hormones and Incident Type 2 Diabetes: A Seven-Year Longitudinal Study

Abstract: Individual changes in TSH and thyroid hormones, even within the normal reference range, were an additional risk factor of incident T2DM.

Cited by 49 publications

References 41 publications

Thyroid-stimulating hormone levels in the normal range and incident type 2 diabetes mellitus

Thyroid-stimulating hormone levels in the normal range and incident type 2 diabetes mellitus

Association of high normal HbA1c and TSH levels with the risk of CHD: a 10-year cohort study and SVM analysis

Thyroid Dysfunction and Diabetes Mellitus: Two Closely Associated Disorders

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