Subclinical thyroid dysfunction and incident diabetes: a systematic review and an individual participant data analysis of prospective cohort studies

被引：14

作者：

Alwan, Heba ^{[1
,2
]}

Villoz, Fanny ^{[1
]}

Feller, Martin ^{[1
]}

Dullaart, Robin P. F. ^{[3
]}

Bakker, Stephan J. L. ^{[3
]}

Peeters, Robin P. ^{[4
,5
]}

Kavousi, Maryam ^{[5
]}

Bauer, Douglas C. ^{[1
,6
,7
]}

Cappola, Anne R. ^{[8
]}

Yeap, Bu B. ^{[9
,10
]}

Walsh, John P. ^{[11
,12
]}

Brown, Suzanne J. ^{[12
]}

Ceresini, Graziano ^{[13
]}

Ferrucci, Luigi ^{[14
]}

Gussekloo, Jacobijn ^{[15
,16
]}

Trompet, Stella ^{[15
]}

Iacoviello, Massimo ^{[17
]}

Moon, Jae Hoon ^{[18
]}

Razvi, Salman ^{[19
]}

Bensenor, Isabela M. ^{[20
]}

Azizi, Fereidoun ^{[21
]}

Amouzegar, Atieh ^{[21
]}

Valdes, Sergio ^{[22
,23
]}

Colomo, Natalia ^{[22
,23
]}

Wareham, Nick J. ^{[24
]}

Jukema, J. Wouter ^{[25
,26
]}

Westendorp, Rudi G. J. ^{[27
,28
]}

Kim, Ki Woong ^{[29
,30
,31
]}

Rodondi, Nicolas ^{[1
,32
]}

Del Giovane, Cinzia ^{[1
]}

机构：

[1] Univ Bern, Inst Primary Hlth Care BIHAM, Bern, Switzerland

[2] Univ Bern, Grad Sch Hlth Sci, Bern, Switzerland

[3] Univ Groningen, Univ Med Ctr Groningen, Dept Internal Med, Groningen, Netherlands

[4] Erasmus MC, Dept Internal Med, Rotterdam, Netherlands

[5] Erasmus MC, Univ Med Ctr Rotterdam, Dept Epidemiol, Rotterdam, Netherlands

[6] Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA

[7] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA USA

[8] Univ Penn, Sch Med, Dept Med, Div Endocrinol Diabet & Metab, Philadelphia, PA 19104 USA

[9] Univ Western Australia, Med Sch, Perth, WA, Australia

[10] Fiona Stanley Hosp, Dept Endocrinol & Diabet, Perth, WA, Australia

[11] Univ Western Australia, Med Sch, Discipline Internal Med, Perth, WA, Australia

[12] Sir Charles Gairdner Hosp, Dept Endocrinol & Diabet, Perth, WA, Australia

[13] Univ Parma, Dept Med & Surg, Parma, Italy

[14] NIA, NIH, Baltimore, MD 21224 USA

[15] Leiden Univ, Med Ctr, Dept Internal Med, Sect Gerontol & Geriatr, Leiden, Netherlands

[16] Leiden Univ, Med Ctr, Dept Publ Hlth & Primary Care, Leiden, Netherlands

[17] Univ Foggia, Dept Med & Surg Sci, Foggia, Italy

[18] Seoul Natl Univ, Bundang Hosp, Coll Med, Dept Internal Med, Seoul, South Korea

[19] Newcastle Univ, Translat & Clin Res Inst, Newcastle Upon Tyne, Tyne & Wear, England

[20] Univ Hosp Sao Paulo, Ctr Clin & Epidemiol Res, Sao Paulo, Brazil

[21] Shahid Beheshti Univ Med Sci, Res Inst Endocrine Sci, Endocrine Res Ctr, Tehran, Iran

[22] Univ Malaga, Hosp Reg Univ Malaga, Inst Invest Biomed Malaga IBIMA, Dept Endocrinol & Nutr, Malaga, Spain

[23] Inst Salud Carlos III, CIBERDEM, Madrid, Spain

[24] Univ Cambridge, Inst Metab Sci, MRC Epidemiol Unit, Cambridge, England

[25] Leiden Univ, Med Ctr, Dept Cardiol, Leiden, Netherlands

[26] Netherlands Heart Inst, Utrecht, Netherlands

[27] Univ Copenhagen, Dept Publ Hlth, Copenhagen, Denmark

[28] Univ Copenhagen, Ctr Hlth Ageing, Copenhagen, Denmark

[29] Seoul Natl Univ, Bundang Hosp, Dept Neuropsychiat, Seongnam, South Korea

[30] Seoul Natl Univ, Coll Nat Sci, Dept Brain & Cognit Sci, Seoul, South Korea

[31] Seoul Natl Univ, Coll Med, Dept Psychiat, Seoul, South Korea

[32] Univ Bern, Bern Univ Hosp, Dept Gen Internal Med, Inselspital, Bern, Switzerland

来源：

EUROPEAN JOURNAL OF ENDOCRINOLOGY | 2022年 / 187卷 / 05期

基金：

美国国家卫生研究院; 英国医学研究理事会; 巴西圣保罗研究基金会; 瑞士国家科学基金会;

关键词：

CORONARY-HEART-DISEASE; METABOLIC SYNDROME; INSULIN-RESISTANCE; RISK-FACTORS; SERUM TSH; HEALTH; HYPOTHYROIDISM; PROGRESSION; PREVALENCE; MORTALITY;

D O I：

10.1530/EJE-22-0523

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

ObjectiveFew prospective studies have assessed whether individuals with subclinical thyroid dysfunction are more likely to develop diabetes, with conflicting results. In this study, we conducted a systematic review of the literature and an individual participant data analysis of multiple prospective cohorts to investigate the association between subclinical thyroid dysfunction and incident diabetes. MethodsWe performed a systematic review of the literature in Medline, Embase, and the Cochrane Library from inception to February 11, 2022. A two-stage individual participant data analysis was conducted to compare participants with subclinical hypothyroidism and subclinical hyperthyroidism vs euthyroidism at baseline and the adjusted risk of developing diabetes at follow-up. ResultsAmong 61 178 adults from 18 studies, 49% were females, mean age was 58 years, and mean follow-up time was 8.2 years. At the last available follow-up, there was no association between subclinical hypothyroidism and incidence of diabetes (odds ratio (OR) = 1.02, 95% CI: 0.88-1.17, I-2 = 0%) or subclinical hyperthyroidism and incidence of diabetes (OR = 1.03, 95% CI: 0.82-1.30, I-2 = 0%), in age- and sex-adjusted analyses. Time-to-event analysis showed similar results (hazard ratio for subclinical hypothyroidism: 0.98, 95% CI: 0.87-1.11; hazard ratio for subclinical hyperthyroidism: 1.07, 95% CI: 0.88-1.29). The results were robust in all sub-group and sensitivity analyses. ConclusionsThis is the largest systematic review and individual participant data analysis to date investigating the prospective association between subclinical thyroid dysfunction and diabetes. We did not find an association between subclinical thyroid dysfunction and incident diabetes. Our results do not support screening patients with subclinical thyroid dysfunction for diabetes. Significance statementEvidence is conflicting regarding whether an association exists between subclinical thyroid dysfunction and incident diabetes. We therefore aimed to investigate whether individuals with subclinical thyroid dysfunction are more prone to develop diabetes in the long run as compared to euthyroid individuals. We included data from 18 international cohort studies with 61 178 adults and a mean follow-up time of 8.2 years. We did not find an association between subclinical hypothyroidism or subclinical hyperthyroidism at baseline and incident diabetes at follow-up. Our results have clinical implications as they neither support screening patients with subclinical thyroid dysfunction for diabetes nor treating them in the hope of preventing diabetes in the future.

引用

页码：S35 / S46

页数：12

共 39 条

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