Association of subtle alterations in thyroid function with presarcopenia in patients with type 2 diabetes mellitus

To investigate the association of subtle alterations in thyroid function with presarcopenia among patients with type 2 diabetes mellitus.

A total of 1,865 adult patients with type 2 diabetes mellitus were enrolled in this cross-sectional study, excluding patients with overt thyroid dysfunction. Skeletal muscle mass measured by dual energy X-ray absorptiometry was used to assess presarcopenia. Logistic regression models were used to estimate the effects of thyroid hormones on presarcopenia, and subgroup analyses were carried out in different strata of age, sex and body mass index, respectively.

Compared with the euthyroid group (Euthy), the subclinical hyperthyroidism group had an increased odds of presarcopenia (multivariate-adjusted odds ratio 1.99, 95% confidence interval 1.09-3.63), but the subclinical hypothyroidism group did not (P > 0.05). In the subclinical hyperthyroidism group, age and body mass index <24 kg/m² were independent risk factors for presarcopenia. In the overall Euthy group, an increased odds of presarcopenia was correlated with the elevated free thyroxine : free triiodothyronine ratio (all P for trend <0.05), whereas not with increment in free triiodothyronine level (P for trend >0.05). Additionally, in Euthy subgroup analyses stratified by middle-age, sex and body mass index, a similar association was noted (all P for trend <0.05), but not in the older-aged patients (P for trend >0.05).

Subclinical hyperthyroidism was an independent risk factor for presarcopenia in patients with type 2 diabetes mellitus, but subclinical hypothyroidism was not. In the Euthy group with type 2 diabetes mellitus, a high free thyroxine : free triiodothyronine ratio was a good index of presarcopenia in addition to older age.