The changes of thyroid hormone in euthyroid patients with diabetes

Abstract

Background Thyroid dysfunction is suggested to be associated with diabetes, but it is not clear if the thyroid hormone levels are associated with diabetes in euthyroid adults. Objective To investigate the association between thyroid hormone levels and diabetes in euthyroid adults. Methods Among the euthyroid adults who underwent health examination in West China Hospital, Sichuan University in 2016, patients with diabetes were identified according to the medical history, fasting blood glucose and HbA1c. Age and sex matched controls were identified from the population. The patients with diabetes group was further divided into two subgroups: patients with newly diagnosed diabetes (NDD) and with previously diagnosed diabetes (PDD). Independent t-test and multivariate logistic regression models were used to investigate the difference on the levels of thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3) and the ratio of FT4/FT3 between groups. Results We included 32,557 participants, 2,271 with diabetes and 1,187 NDD. Compared to the patients without diabetes, the odds ratios (ORs) per one unit of TSH, FT4, FT4/FT3 ratio and FT3 in patients with diabetes were 0.88 [95% confidence interval (CI): 0.82-0.95], 1.11 (95% CI: 1.08-1.14), 2.05 (95%CI: 1.81-2.32) and 0.85 (95%CI: 0.78-0.93), respectively. Compared to NDD group, the ORs per one unit of TSH, FT4, FT4/FT3 ratio and FT3 of the PDD group were 0.81 (95%CI: 0.71-0.92), 1.08 (95%CI: 1.04-1.12), 1.76 (95%CI: 1.49-2.08) and 1.01 (95%CI: 0.92-1.12), respectively. Conclusion In euthyroid adults, diabetes and its duration were significantly associated with thyroid hormone turnover. Patients with a previously diagnosed diabetes may be more likely to present elevated FT4/FT3 ratio, indicating an adaptive change of thyroid gland.

Association between thyroid hormones and diabetic complications in patients with newly diagnosed type 2 diabetes: A cross-sectional study

“…In this study, lower levels of thyroid hormones and a higher prevalence of TD were found in patients with diabetes as compared to the control group, which is in accordance with previous studies [10,11]. The prevalence of TD varied in patients with DM in different regions, ranging from 4% to over 20% [2].…”

Changes in Thyroid Hormones and Free Triiodothyronine-to-Free Thyroxine Ratio in Euthyroid Patients with Obesity in Terms of Different Glucose Metabolism Statuses

“…Our results indicate that the fT4 is independently and positively associated with HbA1c and thus support these findings. Likewise, another study from China has also demonstrated a significant increase in fT4/fT3 ratios of patients with type 2 DM, especially in previously diagnosed ones (28). The minority of the reports about this topic have presented contrary results to this study.…”

Impact of high triglyceride/high-density lipoprotein cholesterol ratio (insulin resistance) in ST-segment elevation myocardial infarction

“…In one previous study, a high mortality rate (17.8% at 1-year follow-up period) was noted in patients with DM and STEMI. [ 37 ] In our study, those with DM, but without a high TG/HDL-C ratio had the worst clinical outcomes (one-year CV mortality: 12.5%; and one-year all-cause mortality: 17.3%). On the other hand, STEMI patients with a low TG/HDL ratio both with and without DM, had worse outcomes.…”

“…Thyroid functions also play an important impact on the TG level and TG/HDL ratio. [ 37 ] In acute illness including STEMI, most patients may present abnormal thyroid function and difficultly interpret. [ 38 , 39 ] Therefore, the relationship between thyroid profile and lipid profile in STEMI patients may need a large cohort study to explore.…”