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Thyroid Hormone Changes in Euthyroid Patients with Diabetes

Authors Qin K, Zhang F, Wu Q, Liu Z, Huang Y, Tan J, Zhou Y, An Z, Li S, Li S

Received 26 April 2020

Accepted for publication 23 June 2020

Published 16 July 2020 Volume 2020:13 Pages 2533—2540

DOI https://doi.org/10.2147/DMSO.S260039

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Dr Konstantinos Tziomalos


Ken Qin,1,* Fan Zhang,1,* Qinqin Wu,1 Zhenrong Liu,1 Yan Huang,1 Jing Tan,2 Yiling Zhou,3 Zhenmei An,3 Shuangqing Li,4 Sheyu Li3,5,6

1Physical Examination Center, West China Hospital, Sichuan University, Chengdu 610041, People’s Republic of China; 2Chinese Evidence-Based Medicine Center CREAT Group, West China Hospital, Sichuan University, Chengdu 610041, People’s Republic of China; 3Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, People’s Republic of China; 4General Medical Center, West China Hospital, Sichuan University, Chengdu 610041, People’s Republic of China; 5Chinese Evidence-Based Medicine Center, Cochrane China Center and MAGIC China Center, West China Hospital, Sichuan University, Chengdu 610041, People’s Republic of China; 6Engineering Research Center for Medical Information Technology, Ministry of Education, West China Hospital of Sichuan University, Chengdu 610041, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Sheyu Li
Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, People’s Republic of China
Tel +86 13194874843
Email lisheyu@gmail.com
Shuangqing Li
General Medical Center, West China Hospital, Sichuan University, Chengdu 610041, People’s Republic of China
Tel +86 18980601354
Email 1259594471@qq.com

Background: Thyroid dysfunction is associated with diabetes, but it is unclear if the thyroid hormone levels change in euthyroid adults with diabetes.
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 of 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 in 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. Compared to the adults without diabetes, the odds ratios (ORs) per one unit elevation 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 the NDD group, the ORs per one unit elevation 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 was associated with increased FT4/FT3 ratio, which is linked to the peripheral turnover of the thyroid hormones.

Keywords: diabetes mellitus, thyroid hormones, triiodothyronine, thyroxine

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