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Association between thyroid dysfunction and type 2 diabetes: a meta-analysis of prospective observational studies
Fen Rong1, Hongji Dai2, Yuwan Wu3
1School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
BMC Medicine
|October 21, 2021
Summary
Thyroid hormone levels, even within normal ranges, may predict type 2 diabetes risk. Abnormal thyroid function, including high TSH or low FT3/FT4, is linked to increased T2DM risk.
Area of Science:
- Endocrinology and Metabolism
- Diabetes Mellitus Research
- Thyroid Disease Studies
Background:
- Thyroid disease and diabetes mellitus are key areas in endocrinology.
- Thyroid hormone variations may indicate future type 2 diabetes mellitus (T2DM) onset, particularly in prediabetes.
- Existing research on this association is inconclusive.
Purpose of the Study:
- To systematically evaluate the association between thyroid function/hormone levels and the risk of developing T2DM.
- To explore dose-response relationships between thyroid function and T2DM risk.
- To assess the link between abnormal thyroid function and cardiovascular disease (CVD) risk in T2DM patients.
Main Methods:
- A meta-analysis of 12 prospective studies identified via MEDLINE and Embase searches up to May 1, 2021.
- Utilized the Sidik-Jonkman random-effects model and cubic spline model for association and dose-response analyses.
- Included studies assessing diabetes incidence and, in a subset, CVD events and mortality.
Main Results:
- High baseline TSH levels correlated with a 17% increased T2DM risk (RR 1.17).
- Low FT3 (RR 1.40) and low FT4 (RR 1.33) levels were significantly associated with higher T2DM risk.
- TSH showed a J-shaped relationship, while FT3 and FT4 exhibited inverted-J-shaped relationships with T2DM risk. No association found between abnormal thyroid function and CVD events or mortality.
Conclusions:
- Abnormal thyroid hormone levels are associated with an elevated risk of developing T2DM.
- The relationship between TSH and T2DM risk is J-shaped.
- The relationships between FT3/FT4 levels and T2DM risk are inverted-J-shaped.
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