Thyroid Hormone Changes in Euthyroid Patients with Diabetes

Ken Qin; Fan Zhang; Qinqin Wu; Zhenrong Liu; Yan Huang; Jing Tan; Yiling Zhou; Zhenmei An; Shuangqing Li; Sheyu Li

doi:10.2147/DMSO.S260039

Thyroid Hormone Changes in Euthyroid Patients with Diabetes

Diabetes Metab Syndr Obes. 2020 Jul 16:13:2533-2540. doi: 10.2147/DMSO.S260039. eCollection 2020.

Authors

Ken Qin^#¹, Fan Zhang^#¹, Qinqin Wu¹, Zhenrong Liu¹, Yan Huang¹, Jing Tan², Yiling Zhou³, Zhenmei An³, Shuangqing Li⁴, Sheyu Li^{3

5

6}

Affiliations

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

^# Contributed equally.

Abstract

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; thyroxine; triiodothyronine.

Grants and funding

This study was supported by 1.3.5 Project for Disciplines of Excellence, West China Hospital, Sichuan University (grant number ZYGD18022) and Sichuan Science and Technology Program (grant numbers 2017RZ0046, 2018SZ0087 and 2019YFH0150). Sheyu Li has also received grants from the National Natural Science Foundation of China (grant number 81400811 and 21534008).